Reversible increase in serum lithium conc & toxicity. Valsartan: Increased incidence of hypotension, hyperkalemia, & changes in renal function w/ other agents acting on the renin-angiotensin-system. May attenuate antihypertensive effect w/ NSAIDs including selective COX-2 inhibitors. Increased risk of worsening of renal function w/ NSAIDs (in elderly, vol depleted, or w/ compromised renal function). K supplements, K-sparing diuretics, salt substitutes containing K, or other drugs that may alter K levels. Hydrochlorothiazide: Potentiated antihypertensive action of other antihypertensive drugs (eg, guanethidine, methyldopa, β-blockers, vasodilators, Ca channel blockers, ACE inhibitors, angiotensin receptor blockers & direct renin inhibitors). Potentiated action of skeletal muscle relaxants (eg, curare derivatives). May increase hypokalemic effect w/ kaliuretic diuretics, corticosteroids, ACTH. May alter glucose tolerance of antidiabetic agents. Induced hypokalemia or hypomagnesemia w/ digitalis glycosides. May weaken the diuretic & antihypertensive activity w/ NSAIDs (eg, salicylic acid derivative, indomethacin). May increase incidence of hypersensitivity reactions to allopurinol. May increase risk of adverse effects w/ amantadine. May reduce renal excretion & enhance the myelosuppressive effects of antineoplastic agents (eg, cyclophosphamide, MTX). May increase bioavailability w/ anticholinergic agents (eg, atropine, biperiden). May decrease bioavailability w/ prokinetic drugs (eg, cisapride). Decreased absorption w/ cholestyramine or colestipol. May potentiate rise in serum Ca of vit D or Ca salts. May increase risk of hyperuricemia & gout-type complications w/ ciclosporin. Hypercalcemia w/ Ca salts. May enhance hyperglycemic effect of diazoxide. Hemolytic anemia w/ methyldopa. May potentiate orthostatic hypotension w/ alcohol, barbiturates, or narcotics. May reduce response to pressor amines eg, noradrenaline.
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