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Adrenocorticotropic hormone, corticosteroids
Increased electrolyte depletion, increasing the risk of hypokalemia.
Alcohol, barbiturates, narcotics
Increased risk of orthostatic hypotension.
Anticholinergic agents (eg, atropine, biperiden)
May increase bioavailability of thiazide-type diuretics.
Antidiabetic agents (oral agents and insulin)
Dosage adjustment of antidiabetic agent may be necessary.
Antihypertensive agent
Additive or potentiation of effects.
Cholestyramine, colestipol resins
Impaired absorption of hydrochlorothiazide.
Cyclosporine
Concomitant use may increase risk of hyperuricemia and gout-type complications.
Digoxin
Thiazide-induced electrolyte disturbances may predispose to digitalis-induced arrhythmias.
Lithium
Plasma concentrations may be elevated by valsartan, increasing the pharmacologic and toxic effects of lithium.
Methyldopa
Reports of hemolytic anemia occurring with concomitant use.
Nondepolarizing skeletal muscle relaxants (eg, tubocurarine)
Increased effect of the muscle relaxant.
Nonsteroidal anti-inflammatory agents
The diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing, and thiazide diuretics may be reduced.
Potassium supplements
May lead to increases in serum potassium. Monitor potassium levels and renal function regularly.
Pressor amines (eg, norepinephrine)
Decreased responsiveness to the pressor amine.
Vitamin D/calcium salts
May potentiate rise in serum calcium.
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