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Drug Interactions between Entresto and potassium chloride

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

potassium chloride valsartan

Applies to: potassium chloride and Entresto (sacubitril / valsartan)

MONITOR CLOSELY: Concomitant use of angiotensin II receptor blockers (ARBs) and potassium salts may increase the risk of hyperkalemia. Inhibition of angiotensin II results in decreased aldosterone secretion, which in turn causes potassium retention. Life-threatening and fatal hyperkalemia can occur, especially when the combination is used in patients with risk factors such as renal impairment, diabetes, advanced age, severe or worsening heart failure, dehydration, and concomitant use of other agents that block the renin-angiotensin-aldosterone system or otherwise increase serum potassium levels.

MANAGEMENT: Caution and close monitoring are advised if angiotensin II receptor blockers (ARBs) must be used concurrently with potassium salts due to the risk of potentially life-threatening hyperkalemia. Some authorities advise against combining certain ARBs with potassium salts unless the anticipated benefits substantially outweigh the potential risks. The risk of hyperkalemia is increased in older patients, those with certain disease states (e.g., renal impairment, diabetes, severe or worsening heart failure, dehydration) or when ARBs are also combined with other agents that increase serum potassium (e.g., nonsteroidal anti-inflammatory drugs, beta-blockers, cyclosporine, heparin, tacrolimus, trimethoprim). Should the benefits outweigh the risks for a particular patient, serum potassium and renal function should be checked prior to initiating therapy and regularly thereafter. Patients and their caregivers should be given counseling on the appropriate levels of potassium and fluid intake, and advised to seek medical attention if they experience signs and symptoms of hyperkalemia (e.g., nausea, vomiting, weakness, listlessness, tingling of the extremities, paralysis, confusion, weak pulse, and a slow or irregular heartbeat). Individual product labeling should be consulted for further guidance.

References

  1. Walmsley RN, White GH, Cain M, McCarthy PJ, Booth J (1984) "Hyperkalemia in the elderly." Clin Chem, 30, p. 1409-12
  2. Lawson DH, O'Connor PC, Jick H (1982) "Drug attributed alterations in potassium handling in congestive cardiac failure." Eur J Clin Pharmacol, 23, p. 21-5
  3. Lawson DH (1974) "Adverse reactions to potassium chloride." Q J Med, 43, p. 433-40
  4. (2001) "Product Information. Cozaar (losartan)." Merck & Co., Inc
  5. (2001) "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals
  6. Obialo CI, Ofili EO, Mirza T (2002) "Hyperkalemia in congestive heart failure patients aged 63 to 85 years with subclinical renal disease." Am J Cardiol, 90, p. 663-5
  7. Jarman PR, Mather HM (2003) "Diabetes may be independent risk factor for hyperkalaemia." BMJ, 327, p. 812
  8. Perazella MA (2000) "Drug-induced hyperkalemia: old culprits and new offenders." Am J Med, 109, p. 307-14
  9. Jarman PR, Kehely AM, Mather HM (1995) "Hyperkalaemia in diabetes: prevalence and associations." Postgrad Med J, 71, p. 551-2
  10. Perazella MA, Mahnensmith RL (1997) "Hyperkalemia in the elderly: drugs exacerbate impaired potassium homeostasis." J Gen Intern Med, 12, p. 646-56
  11. Large DM, Carr PH, Laing I, Davies M (1984) "Hyperkalaemia in diabetes mellitus--potential hazards of coexisting hyporeninaemic hypoaldosteronism." Postgrad Med J, 60, p. 370-3
  12. (2021) "Product Information. Irbesartan (irbesartan)." Alembic Pharmaceuticals
  13. (2022) "Product Information. Avapro (irbesartan)." Sanofi-Aventis Canada Inc
  14. (2021) "Product Information. Aprovel (irbesartan)." Sanofi
  15. (2021) "Product Information. Valsartan (valsartan)." Alembic Pharmaceuticals
  16. (2023) "Product Information. Auro-Valsartan (valsartan)." Auro Pharma Inc
  17. (2023) "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals UK Ltd
  18. (2020) "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals Pty Ltd
  19. (2023) "Product Information. Telmisartan (telmisartan)." Alembic Pharmaceuticals
  20. (2023) "Product Information. Ach-Telmisartan (telmisartan)." Accord Healthcare Inc
  21. (2023) "Product Information. Micardis (telmisartan)." Boehringer Ingelheim Ltd
  22. (2022) "Product Information. Micardis (telmisartan)." Boehringer Ingelheim Pty Ltd
  23. (2022) "Product Information. Olmesartan Medoxomil (olmesartan)." ASCEND LABORATORIES S.P.A.
  24. (2022) "Product Information. Olmesartan Medoxomil (olmesartan)." Thornton & Ross Ltd
  25. (2022) "Product Information. IXIA (olmesartán)." MENARINI INTERNATIONAL OPERATIONS LUXEMBOURG, S.A.
  26. (2024) "Product Information. Losartan Potassium (losartan)." Strides Pharma Inc.
  27. (2023) "Product Information. Auro-Losartan (losartan)." Auro Pharma Inc
  28. (2022) "Product Information. Cozaar (losartan)." Organon Pharma (UK) Ltd
  29. (2022) "Product Information. Eprosartan (eprosartan)." Amarox Ltd
  30. (2021) "Product Information. Candesartan Cilexetil (candesartan)." Alembic Pharmaceuticals
  31. (2022) "Product Information. Amias (candesartan)." Neon Healthcare Ltd
  32. (2022) "Product Information. Edarbi (azilsartan)." Takeda UK Ltd
  33. (2020) "Product Information. DIOVAN (valsartán)." NOVARTIS FARMA S.P.A.
  34. (2008) "Product Information. MICARDIS (telmisartán)." BOEHRINGER INGELHEIM ESPAÑA, S.A.
  35. (2022) "Product Information. IXIA (olmesartán)." MENARINI,S.A.
  36. (2022) "Product Information. COZAAR (losartán)." Organon Pharmaceuticals
  37. (2021) "Product Information. IRBESARTAN CINFA (irbesartán)." CINFA S.A.
  38. (2022) "Product Information. FUTURAN (eprosartán)." VIATRIS
  39. (2021) "Product Information. CANDESARTAN CINFA (candesartán)." CINFA S.A.
View all 39 references

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Drug and food interactions

Moderate

valsartan food

Applies to: Entresto (sacubitril / valsartan)

GENERALLY AVOID: Moderate-to-high dietary intake of potassium, especially salt substitutes, may increase the risk of hyperkalemia in some patients who are using angiotensin II receptor blockers (ARBs). ARBs can promote hyperkalemia through inhibition of angiotensin II-induced aldosterone secretion. Patients with diabetes, heart failure, dehydration, or renal insufficiency have a greater risk of developing hyperkalemia.

MANAGEMENT: Patients should receive dietary counseling and be advised to not use potassium-containing salt substitutes or over-the-counter potassium supplements without consulting their physician. If salt substitutes are used concurrently, regular monitoring of serum potassium levels is recommended. Patients should also be advised to seek medical attention if they experience symptoms of hyperkalemia such as weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs.

References

  1. (2001) "Product Information. Cozaar (losartan)." Merck & Co., Inc
  2. (2001) "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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