मोएक्सिप्रिल और ओल्मेसार्टन, एम्लोडिपिन और हाइड्रोक्लोरोथायज़ाइड का इंटरैक्शन

Symptomatic hypotension is most likely to occur in patients who have been salt- and volume- depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting.

Volume- and salt-depletion should be corrected and, in general, diuretics stopped, before initiating therapy with moexipril hydrochloride (see PRECAUTIONS, Drug Interactions , and ADVERSE REACTIONS ).

In these patients, moexipril hydrochloride therapy should be started under close medical supervision, and patients should be followed closely for the first two weeks of treatment and whenever the dose of moexipril or an accompanying diuretic is increased.

Drug Interactions Diuretics: Excessive reductions in blood pressure may occur in patients on diuretic therapy when ACE inhibitors are started.

Potassium Supplements and Potassium-Sparing Diuretics: Moexipril hydrochloride can increase serum potassium because it decreases aldosterone secretion.

In studies of ACE inhibitors in patients with unilateral or bilateral renal artery stenosis, increases in serum creatinine or blood urea nitrogen (BUN) have been reported.

Dual Blockade of the Renin-Angiotensin System (RAS): Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy.

In patients whose renal function may depend upon the activity of the renin-angiotensin-aldosterone system (e.g., patients with severe congestive heart failure), treatment with ACE inhibitors and angiotensin receptor antagonists has been associated with oliguria or progressive azotemia and (rarely) with acute renal failure and/or death.