Drug interactions
Sacubitril / valsartan + Telmisartan-amlodipine
Severity: Major
Sacubitril / valsartan and Telmisartan-amlodipine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining two angiotensin receptor blockers gives dual blockade of the renin-angiotensin system. This raises the risk of hyperkalemia, hypotension and acute kidney injury without added benefit.
What this interaction means in plain words
Sacubitril / valsartan and Telmisartan-amlodipine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Duplicate angiotensin II type 1 receptor blockade reduces aldosterone-mediated potassium excretion and lowers renal perfusion pressure.
What to do
Avoid using telmisartan together with sacubitril/valsartan and keep only one ARB-containing agent. If unavoidable, monitor serum potassium, creatinine and blood pressure closely.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Telmisartan-amlodipine
- Aliskiren + Telmisartan-amlodipine Contraindicated
- Sparsentan + Telmisartan-amlodipine Contraindicated
- Amifostine + Telmisartan-amlodipine Major
- Amiloride + Telmisartan-amlodipine Major
- Benazepril + Telmisartan-amlodipine Major
- Candesartan + Telmisartan-amlodipine Major
Frequently asked questions
Can I take Sacubitril / valsartan with Telmisartan-amlodipine?
MediHelp rates the interaction as major. Sacubitril / valsartan and Telmisartan-amlodipine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Combining two angiotensin receptor blockers gives dual blockade of the renin-angiotensin system. This raises the risk of hyperkalemia, hypotension and acute kidney injury without added benefit.
How serious is the interaction between Sacubitril / valsartan and Telmisartan-amlodipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid using telmisartan together with sacubitril/valsartan and keep only one ARB-containing agent. If unavoidable, monitor serum potassium, creatinine and blood pressure closely.
What other medicines interact with Telmisartan-amlodipine?
MediHelp also lists interactions of Telmisartan-amlodipine with, for example, Aliskiren, Sparsentan, Amifostine. The full list is on the Telmisartan-amlodipine page.
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