RiteMED Irbesartan Drug Interactions

Potassium-sparing diuretics/potassium supplements/salt substitutes: May increase serum potassium; thus, coadministration is not recommended.
Lithium: Reversible increases in serum lithium concentrations and toxicity; thus, coadministration is not recommended. If coadministration proves necessary, monitor serum lithium levels carefully.
Nonsteroidal anti-inflammatory drugs [NSAIDs, i.e., selective cyclooxygenase-2 (COX-2) inhibitors, aspirin >3 g/day]: Reduced antihypertensive effect of irbesartan. Concurrent administration of angiotensin II receptor antagonists with NSAIDs may result in an increased risk of worsening of renal function (including possible acute renal failure) and an increase in serum potassium, particularly in patients with poor pre-existing renal function. The combination should be administered with caution, especially in the elderly. Regularly monitor renal function after initiation of concomitant therapy and adequately hydrate patients.
Dual Blockade of the Renin-Angiotensin-Aldosterone System (RAAS): Dual blockade of the RAAS with angiotensin II receptor blockers, ACE inhibitors or aliskiren is associated with increased risk of hypotension, hyperkalemia and changes in renal function (including acute renal failure) compared with monotherapy. Closely monitor blood pressure, renal function and electrolytes in patients on irbesartan and other agents that affect the RAAS.
Do not coadminister irbesartan with aliskiren in patients with diabetes mellitus or renal impairment (GFR <60 mL/min/1.73 m²). Avoid concomitant use of ACE inhibitors and angiotensin II receptor blockers in patients with diabetic nephropathy.
Other antihypertensive agents: Other antihypertensive agents may increase irbesartan's hypotensive effects; however, irbesartan has been safely given with other antihypertensive agents, such as beta-blockers, long-acting calcium channel blockers and thiazide diuretics. Prior treatment with high dose diuretics may result in volume depletion and a risk of hypotension when initiating treatment with irbesartan.
Coadministration of irbesartan with other drugs such as hydrochlorothiazide, digoxin, warfarin, and nifedipine showed no significant drug pharmacokinetic or pharmacodynamic interactions.