Amiloride + Amlodipine-hydrochlorothiazide-valsartan

MediHelp rates the interaction as major. Amiloride and Amlodipine-hydrochlorothiazide-valsartan 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. Amiloride is a potassium-sparing diuretic and valsartan reduces aldosterone-mediated potassium excretion, so together they can cause significant hyperkalemia, particularly in renal impairment, diabetes or older patients. The thiazide component partly offsets this by wasting potassium, but the net effect is unpredictable.

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum potassium and renal function within the first week of combining and periodically thereafter. Avoid potassium supplements and salt substitutes, and stop amiloride if potassium rises above the normal range.

MediHelp also lists interactions of Amlodipine-hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Amlodipine-hydrochlorothiazide-valsartan page.