Stockley’s Drug Interactions Pocket Companion Latest Edition Ebook PDF
Stockley’s Drug Interactions Pocket Companion Latest Edition Ebook PDF Most ACE inhibitor interactions are pharmacodynamic, that is, interactions that result in an alteration in drug effects rather than drug disposition, so in most cases interactions of individual drugs will be applicable to the group as a whole. The ACE inhibitors do not appear to undergo interactions via cytochrome P450 isoenzymes.ACE inhibitors + Aliskiren The concurrent use of ACE inhibitors and aliskiren increases the risk of hyperkalaemia.
Additive hypotension is likely to occur, which can be clinically beneficial, see also antihypertensives, page 97.
Monitor potassium concentrations with concurrent use, particularly in patients at
high risk of hyperkalaemia (such as those with reduced renal function and/or
diabetes). Note that, in December 2011, the European Medicines Agency stated
that aliskiren-containing medicines should not be given to diabetic patients in
combination with ACE inhibitors.
ACE inhibitors + Allopurinol
A case of hypersensitivity has been attributed to the concurrent use of captopril and allopurinol. Other ACE inhibitors may interact similarly. Anaphylaxis and myocardial infarction occurred in one man taking enalapril with allopurinol. The combination of ACE inhibitors and allopurinol might increase the risk of leucopenia and serious infection.
Patients taking both drugs should be very closely monitored for any signs of
hypersensitivity (e.g. skin reactions) or low white cell count (sore throat, fever),
especially if they have renal impairment. White blood cell counts should be
monitored periodically: some manufacturers suggest checking before starting allopurinol, then every 2 weeks during the first 3 months of treatment, and periodically thereafter.