Drug Interactions between aliskiren / valsartan and vimseltinib

Using aliskiren together with valsartan may increase the risk of serious side effects such as kidney problems, low blood pressure, and high potassium levels in the blood. High levels of potassium can develop into a condition known as hyperkalemia, which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. These medications should generally not be used together, particularly if you are diabetic or have preexisting kidney problems. Other risk factors include advanced age, dehydration, severe heart failure, or recent heart attack. Talk to you doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important that you maintain adequate fluid intake during treatment with these medications. Ask your doctor if it is necessary for you to limit consumption of potassium-rich foods such as tomatoes, raisins, figs, potatoes, lima beans, bananas, plantains, papayas, pears, cantaloupes, mangoes, and potassium-containing salt substitutes. You should seek medical attention if you experience nausea, vomiting, weakness, confusion, tingling of the hands and feet, feelings of heaviness in the legs, a weak pulse, or a slow or irregular heartbeat, as these may be symptoms of hyperkalemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with inhibitors of CYP450 3A4 and P-glycoprotein may increase the plasma concentrations and pharmacologic effects of aliskiren, which is a substrate of both the isoenzyme and efflux transporter. According to the product labeling, plasma levels of aliskiren were increased approximately 80% by the potent CYP450 3A4 and moderate P-gp inhibitor ketoconazole at a dosage of 200 mg twice daily. A 400 mg once daily dose of ketoconazole was not studied, but would be expected to further increase the magnitude of interaction. Similarly, plasma levels of aliskiren increased by approximately 2-fold when coadministered with the moderate CYP450 3A4 and potent P-gp inhibitor verapamil at a dosage of 240 mg once daily.

MANAGEMENT: Pharmacologic response to aliskiren should be monitored more closely whenever a CYP450 3A4 and/or P-gp inhibitor is added to or withdrawn from therapy, and the aliskiren dosage adjusted if necessary. Patients should be advised to notify their physician if they experience excessive adverse effects of aliskiren such as dizziness, lightheadedness, diarrhea, abdominal pain, and gastroesophageal reflux. The individual product labeling of the coadministered drug should be consulted for further guidance.