Sacubitril and valsartan interactions

Sacubitril and valsartan (Entresto), an angiotensin II receptor blocker (ARB) has 121 documented interactions across the FDA labels and fact sheets we index: 18 major, 81 moderate, 22 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Major interactions (18)

  • AliskirenantihypertensiveMajor

    Do not administer within 36 hours of switching from or to an ACE inhibitor [see Drug Interactions (7.1)] with concomitant use of aliskiren in patients with diabetes [see Drug Interactions (7.1)] Hypersensitivity to any component. (Sacubitril and valsartan label, Contraindications)

  • Amlodipine and benazeprildihydropyridine calcium channel blockerMajor

    ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

  • BenazeprilACE inhibitorMajor

    ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

  • CaptoprilACE inhibitorMajor

    ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

  • ClozapineantipsychoticMajor

    Use CLOZARIL cautiously in patients with cardiovascular or cerebrovascular disease or conditions predisposing to hypotension (e.g., dehydration, use of antihypertensive medications) [see Dosage and Administration ( 2.2 , 2.6 ), Warnings and Precautions ( 5.2 )]. (Clozapine label, Boxed warning)

  • EnalaprilACE inhibitorMajor

    ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

  • FosinoprilACE inhibitorMajor

    ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

  • LisinoprilACE inhibitorMajor

    ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

  • ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

  • Metolazonethiazide diureticMajor

    Other Antihypertensive Drugs When metolazone tablets, USP, are used with other antihypertensive drugs, particular care must be taken to avoid excessive reduction of blood pressure, especially during initial therapy. (Metolazone label, Warnings)

  • MinoxidilvasodilatorMajor

    Minoxidil should be reserved for hypertensive patients who do not respond adequately to maximum therapeutic doses of a diuretic and two other antihypertensive agents. (Minoxidil label, Boxed warning)

  • MoexiprilACE inhibitorMajor

    ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

  • PerindoprilACE inhibitorMajor

    ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

  • PotassiumVitamin and mineralMajor

    These medicines reduce potassium excretion; adding potassium supplements or salt substitutes can cause hyperkalemia, which affects heart rhythm. (NIH Office of Dietary Supplements, Potassium)

  • QuinaprilACE inhibitorMajor

    ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

  • RamiprilACE inhibitorMajor

    ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

  • TadalafilPDE5 inhibitorMajor

    …coadministration of an alpha-blocker and CIALIS for the treatment of BPH has not been adequately studied, and due to the potential vasodilatory effects of combined use resulting in blood pressure lowering, the combination of CIALIS and alpha-blockers is not recommended for the treatment of BPH. [see Dosage and Administration ( 2.7 ), Drug Interactions ( 7.1 ),… (Tadalafil label, Warnings and precautions)

  • TrandolaprilACE inhibitorMajor

    ENTRESTO is contraindicated: in patients with hypersensitivity to any component in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy [see Warnings and Precautions (5.2)] with concomitant use of ACE inhibitors. (Sacubitril and valsartan label, Contraindications)

Moderate interactions (81)

  • Acetazolamidecarbonic anhydrase inhibitorModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • Alfuzosinalpha blockerModerate

    Postural hypotension/syncope: Care should be taken in patients with symptomatic hypotension or who have had a hypotensive response to other medications or are concomitantly treated with antihypertensive medication or nitrates ( 5.1 ) (Alfuzosin label, Warnings and precautions)

  • Amiloridepotassium-sparing diureticModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • AripiprazoleantipsychoticModerate

    Antihypertensive Drugs Due to its alpha-adrenergic antagonism, aripiprazole has the potential to enhance the effect of certain antihypertensive agents. (Aripiprazole label, Drug interactions)

  • ArmodafinilCNS stimulantModerate

    There was also a slightly greater proportion of patients on NUVIGIL requiring new or increased use of antihypertensive medications (2.9%) compared to patients on placebo (1.8%). (Armodafinil label, Warnings and precautions)

  • AsenapineantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medications, patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Asenapine label, Warnings and precautions)

  • AspirinNSAIDModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • Aspirin and dipyridamoleantiplatelet agentModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • Atenololbeta blockerModerate

    Because of its relative beta 1 selectivity, however, TENORMIN may be used with caution in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Atenolol label, Warnings)

  • Atomoxetinenorepinephrine reuptake inhibitorModerate

    Antihypertensive Drugs Prevention or Management Increase the frequency of monitoring blood pressure and adjust atomoxetine oral solution dosage as clinically appropriate. (Atomoxetine label, Drug interactions)

  • AvanafilPDE5 inhibitorModerate

    • Use of avanafil with alpha-blockers, other antihypertensives, or substantial amounts of alcohol (greater than 3 units) may lead to hypotension ( 2.3 , 5.6 , 5.7 ) (Avanafil label, Warnings and precautions)

  • Bisoprololbeta blockerModerate

    Because of its relative beta 1 -selectivity, however, BISOPROLOL FUMARATE may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol label, Warnings)

  • Bisoprolol and hydrochlorothiazidebeta blockerModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • BrexpiprazoleantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medication), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Brexpiprazole label, Warnings and precautions)

  • Brimonidinealpha-adrenergic agonistModerate

    Antihypertensives/Cardiac Glycosides Because brimonidine tartrate ophthalmic solution 0.1% and 0.15% may reduce blood pressure, caution in using drugs such as antihypertensives and/or cardiac glycosides with brimonidine tartrate ophthalmic solution 0.1% and 0.15% is advised. (Brimonidine label, Drug interactions)

  • Bumetanideloop diureticModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • Carbidopa and levodopadopaminergic drugModerate

    Antihypertensive drugs: May cause symptomatic postural hypotension. (Carbidopa and levodopa label, Drug interactions)

  • CariprazineantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Cariprazine label, Warnings and precautions)

  • Carvedilolbeta blockerModerate

    COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

  • CelecoxibNSAIDModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • Chlorthalidonethiazide diureticModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • Cyclobenzaprinemuscle relaxantModerate

    …concomitant use of TONMYA with: MAO inhibitors may be life-threatening [see Contraindications (4) ] , Alcohol, barbiturates, and other CNS depressants may increase the risk of adverse reactions associated with these drugs, Tramadol may increase the seizure risk, Guanethidine or other similar acting drugs may block the antihypertensive action of these drugs. (Cyclobenzaprine label, Drug interactions)

  • CyclosporineimmunosuppressantModerate

    Caution is also required when cyclosporine is coadministered with potassium sparing drugs (e.g., angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists), potassium-containing drugs as well as in patients on a potassium rich diet. (Cyclosporine label, Drug interactions)

  • Dalfampridinepotassium supplementModerate

    Potassium-Sparing Diuretics As with other drugs that block angiotensin II or its effects, concomitant use of potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, or salt substitutes containing potassium may lead to increases in serum potassium [see Warnings and Precautions (5.5)] . (Sacubitril and valsartan label, Drug interactions)

  • DapagliflozinSGLT2 inhibitorModerate

    …Glimepiride (4 mg) 20 mg ↔ ↔ Voglibose (0.2 mg three times daily) 10 mg ↔ ↔ Other Medications Hydrochlorothiazide (25 mg) 50 mg ↔ ↔ Bumetanide (1 mg) 10 mg once daily for 7 days ↔ ↔ Valsartan (320 mg) 20 mg ↓12% [↓3%, ↓20%] ↔ Simvastatin (40 mg) 20 mg ↔ ↔ Anti-infective Agent Rifampin (600 mg once daily for 6 days) 10 mg ↓7% [↓22%, ↑11%] ↓22% [↓27%, ↓17%] Nonsteroidal… (Dapagliflozin label, Drug interactions)

  • DexmethylphenidateCNS stimulantModerate

    Antihypertensive Drugs: Monitor blood pressure. (Dexmethylphenidate label, Drug interactions)

  • DiclofenacNSAIDModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • Drospirenone and ethinyl estradioloral contraceptiveModerate

    Medications that may increase serum potassium concentration include ACE inhibitors, angiotensin-II receptor antagonists, potassium-sparing diuretics, potassium supplementation, heparin, aldosterone antagonists, and NSAIDS. (Drospirenone and ethinyl estradiol label, Warnings and precautions)

  • DuloxetineSNRIModerate

    The risk of BP decreases may be greater in patients taking concomitant medications that induce orthostatic hypotension (such as antihypertensives) or are potent CYP1A2 inhibitors [see Warnings and Precautions ( 5.12 ) and Drug Interactions ( 7.1 )] and in patients taking CYMBALTA at doses above 60 mg daily. (Duloxetine label, Warnings and precautions)

  • EpinephrinesympathomimeticModerate

    Epinephrine may antagonize the neuronal blockade produced by guanethidine resulting in decreased antihypertensive effect and requiring increased dosage of the latter. (Epinephrine label, Drug interactions)

  • Eplerenonealdosterone antagonistModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • Epoetin alfaModerate

    Following initiation and titration of Epogen, approximately 25% of patients on dialysis required initiation of or increases in antihypertensive therapy; hypertensive encephalopathy and seizures have been reported in patients with CKD receiving Epogen. (Epoetin alfa label, Warnings and precautions)

  • Esmololbeta blockerModerate

    Antihypertensive agents clonidine, guanfacine, or moxonidine: Beta blockers also increase the risk of clonidine-, guanfacine-, or moxonidine-withdrawal rebound hypertension. (Esmolol label, Drug interactions)

  • Ethacrynic acidloop diureticModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • EtodolacNSAIDModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • Furosemideloop diureticModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • GemfibrozilfibrateModerate

    OATP1B1 substrates – Gemfibrozil is an inhibitor of organic anion-transporter polyprotein (OATP) 1B1 and may increase exposure of drugs that are substrates of OATP1B1 (e.g., atrasentan, atorvastatin, bosentan, ezetimibe, fluvastatin, glyburide, SN-38 [active metabolite of irinotecan], rosuvastatin, pitavastatin, pravastatin, rifampin, valsartan, olmesartan). (Gemfibrozil label, Warnings)

  • HaloperidolantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are at risk for hypotension (e.g., geriatric patients, patients with dehydration, hypovolemia, and concomitantly treated with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Haloperidol label, Warnings and precautions)

  • Hydrochlorothiazidethiazide diureticModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • IbuprofenNSAIDModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • IloperidoneantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Iloperidone label, Warnings and precautions)

  • Indapamidethiazide diureticModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • IndomethacinNSAIDModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • KetorolacNSAIDModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • Lithiumserotonergic drugModerate

    Lithium: Increased risk of lithium toxicity. (Sacubitril and valsartan label, Drug interactions)

  • Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • LumateperoneantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive drugs), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Lumateperone label, Warnings and precautions)

  • LurasidoneantipsychoticModerate

    Patients at increased risk of these adverse reactions or at increased risk of developing complications from hypotension include those with dehydration, hypovolemia, treatment with antihypertensive medication, history of cardiovascular disease (e.g., heart failure, myocardial infarction, ischemia, or conduction abnormalities), history of cerebrovascular disease,… (Lurasidone label, Warnings and precautions)

  • MeloxicamNSAIDModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • MethylphenidateCNS stimulantModerate

    Antihypertensive Drugs: Monitor blood pressure. (Methylphenidate label, Drug interactions)

  • MirtazapineantidepressantModerate

    REMERON/REMERONSolTab should be used with caution in patients with known cardiovascular or cerebrovascular disease that could be exacerbated by hypotension (history of myocardial infarction, angina, or ischemic stroke) and conditions that would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medication). (Mirtazapine label, Warnings and precautions)

  • ModafinilCNS stimulantModerate

    However, a retrospective analysis of the use of antihypertensive medication in these studies showed that a greater proportion of patients on PROVIGIL required new or increased use of antihypertensive medications (2.4%) compared to patients on placebo (0.7%). (Modafinil label, Warnings and precautions)

  • NabumetoneNSAIDModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • NaproxenNSAIDModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • NiacinModerate

    Antihypertensive Therapy Niacin may potentiate the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension. (Niacin label, Drug interactions)

  • NitroglycerinnitrateModerate

    Antihypertensives: Possible additive hypotensive effects. (Nitroglycerin label, Drug interactions)

  • OlanzapineantipsychoticModerate

    …of myocardial infarction or ischemia, heart failure, or conduction abnormalities), cerebrovascular disease, and conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications) where the occurrence of syncope, or hypotension and/or bradycardia might put the patient at increased medical risk. (Olanzapine label, Warnings and precautions)

  • PaliperidoneantipsychoticModerate

    Use ERZOFRI with caution in patients with known cardiovascular disease (e.g., heart failure, history of myocardial infarction or ischemia, conduction abnormalities), cerebrovascular disease, or conditions that predispose the patient to hypotension (e.g., dehydration, hypovolemia, and treatment with antihypertensive medications). (Paliperidone label, Warnings and precautions)

  • PentoxifyllinemethylxanthineModerate

    Small decreases in blood pressure have been observed in some patients treated with pentoxifylline extended-release tablets; periodic systemic blood pressure monitoring is recommended for patients receiving concomitant antihypertensive therapy. (Pentoxifylline label, Drug interactions)

  • PhenelzineMAO inhibitorModerate

    …hydrochloride desipramine hydrochloride imipramine hydrochloride doxepin carbamazepine cyclobenzaprine HCl amoxapine maprotiline HCl trimipramine maleate protriptyline HCl mirtazapine Phenelzine sulfate should be used with caution in combination with antihypertensive drugs, including thiazide diuretics and β-blockers, since exaggerated hypotensive effects may result. (Phenelzine label, Warnings)

  • Potassium chloridepotassium supplementModerate

    Potassium-Sparing Diuretics As with other drugs that block angiotensin II or its effects, concomitant use of potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, or salt substitutes containing potassium may lead to increases in serum potassium [see Warnings and Precautions (5.5)] . (Sacubitril and valsartan label, Drug interactions)

  • Prazosinalpha blockerModerate

    Syncopal episodes have usually occurred within 30 to 90 minutes of the initial dose of the drug; occasionally, they have been reported in association with rapid dosage increases or the introduction of another antihypertensive drug into the regimen of a patient taking high doses of prazosin hydrochloride capsules. (Prazosin label, Warnings)

  • QuetiapineantipsychoticModerate

    Quetiapine should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Quetiapine label, Warnings and precautions)

  • RepaglinidemeglitinideModerate

    Potassium-Sparing Diuretics As with other drugs that block angiotensin II or its effects, concomitant use of potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, or salt substitutes containing potassium may lead to increases in serum potassium [see Warnings and Precautions (5.5)] . (Sacubitril and valsartan label, Drug interactions)

  • RiociguatvasodilatorModerate

    Consider the potential for symptomatic hypotension or ischemia in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, or concomitant treatment with antihypertensives or strong CYP and P-gp/BCRP inhibitors [see Drug Interactions (7.2) and Clinical Pharmacology (12.3) ] . (Riociguat label, Warnings and precautions)

  • RisperidoneantipsychoticModerate

    Clinically significant hypotension has been observed with concomitant use of oral RISPERDAL and antihypertensive medication. (Risperidone label, Warnings and precautions)

  • SildenafilPDE5 inhibitorModerate

    Caution is advised when SILDENAFIL ORAL FILM is co-administered with alpha-blockers or antihypertensives. (Sildenafil label, Warnings and precautions)

  • Spironolactonealdosterone antagonistModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • Spironolactone and hydrochlorothiazidealdosterone antagonistModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • Sumatriptan and naproxentriptanModerate

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)

  • TacrolimusimmunosuppressantModerate

    • Hypertension: May require antihypertensive therapy; monitor relevant drug interactions. (Tacrolimus label, Warnings and precautions)

  • Terazosinalpha blockerModerate

    Risk of Hypotension with Concomitant Use of Other Antihypertensive Agents and Phospodiesterase Type 5 Inhibitors (PDE5-I): Concomitant administration of TEZRULY with antihypertensives or phosphodiesterase-5 (PDE-5) inhibitors can result in additive blood pressure lowering effects and symptomatic hypotension (5.3). (Terazosin label, Warnings and precautions)

  • TestosteroneandrogenModerate

    In patients with hypertension on antihypertensive therapy, KYZATREX® increased the mean systolic/diastolic BP by 3.4/0.7 mm Hg from baseline after 4 months of treatment and 3.1/1.0 mm Hg from baseline after 6 months of treatment. [see Adverse Reactions (6.1) ]. (Testosterone label, Warnings and precautions)

  • Torsemideloop diureticModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • TrazodoneantidepressantModerate

    Concomitant use with an antihypertensive may require a reduction in the dose of the antihypertensive drug. (Trazodone label, Warnings and precautions)

  • Triamterenepotassium-sparing diureticModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • Triamterene and hydrochlorothiazidepotassium-sparing diureticModerate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • VardenafilPDE5 inhibitorModerate

    Vardenafil hydrochloride tablets can potentiate the hypotensive effects of nitrates, alpha- blockers, and antihypertensives. (Vardenafil label, Drug interactions)

  • VenlafaxineSNRIModerate

    Metoprolol: Possibly reduced blood-pressure lowering effect despite increased metoprolol plasma levels. (Venlafaxine label, Drug interactions)

  • ZiprasidoneantipsychoticModerate

    Ziprasidone should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Ziprasidone label, Warnings and precautions)

Minor mentions (22)

  • AzelastineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • ButorphanolopioidMinor

    In such cases, butorphanol should be discontinued and the hypertension treated with antihypertensive drugs. (Butorphanol label, Warnings)

  • CetirizineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • ChlorpheniramineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • ChlorpromazineantipsychoticMinor

    Chlorpromazine may counteract the antihypertensive effect of guanethidine and related compounds. (Chlorpromazine label, Warnings)

  • DimenhydrinateantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • DiphenhydramineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • DoxylamineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • FexofenadineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • HydralazinevasodilatorMinor

    When other potent parenteral antihypertensive drugs, such as diazoxide, are used in combination with hydralazine, patients should be continuously observed for several hours for any excessive fall in blood pressure. (Hydralazine label, Drug interactions)

  • HydroxyzineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • Isradipinedihydropyridine calcium channel blockerMinor

    In a study in hypertensive patients, addition of isradipine to existing hydrochlorothiazide therapy did not result in any unexpected adverse effects, and isradipine had an additional antihypertensive effect. (Isradipine label, Drug interactions)

  • LevocetirizineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • LoratadineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • MeclizineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • MethyldopaantihypertensiveMinor

    Drug Interactions When methyldopa is used with other antihypertensive drugs, potentiation of antihypertensive effect may occur. (Methyldopa label, Drug interactions)

  • Metoprololbeta blockerMinor

    Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)

  • Nisoldipinedihydropyridine calcium channel blockerMinor

    The blood pressure effect of SULAR tended to be greater in patients on atenolol than in patients on no other antihypertensive therapy. (Nisoldipine label, Drug interactions)

  • Nortriptylinetricyclic antidepressantMinor

    The antihypertensive action of guanethidine and similar agents may be blocked. (Nortriptyline label, Warnings)

  • OlopatadineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

  • ProchlorperazineantipsychoticMinor

    Antihypertensive effects of guanethidine and related compounds may be counteracted when phenothiazines are used concomitantly. (Prochlorperazine label, Precautions)

  • PromethazineantihistamineMinor

    In cases of confirmed angioedema where swelling has been confined to the face and lips, the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. (Sacubitril and valsartan label, Warnings and precautions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.