• Potassium supplements. Use increases the risk of hyperkalemia (too much potassium in the body).

  • Salt substitutes or other low-salt products that use potassium chloride. Use increases the risk of hyperkalemia.

  • Diuretics (some types). Medications that stimulate the kidneys to produce more urine, flushing excess fluids and minerals (e.g., sodium) from the body. Most diuretics cause the body to lose potassium, as well as sodium and fluids. One type – potassium-sparing diuretics – actually preserves potassium while flushing other minerals from the body. Because of this, using potassium-sparing diuretics in conjunction with ARBs may increase the risk of hyperkalemia.

    It is important to note that potassium-sparing diuretics may be also be prescribed to treat high blood pressure. To avoid potentially dangerous complications, patients should be sure to tell their physician about any medication or remedy they are taking before starting a new medication.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). These can decrease the effectiveness of the ARBs, worsen high blood pressure or increase the risk of kidney problems. Patients should consult with their physician before using them. A possible exception to this is aspirin. Though aspirin is technically a type of NSAID, research has suggested that aspirin use – especially the low doses associated with daily aspirin therapy – may be beneficial for heart patients. Patients should discuss the potential benefits and risks of aspirin therapy with their physicians.

  • Insulin and antidiabetic medications. Use of certain ARBs may increase the effect of these medications on insulin levels in the body.

  • Some antidepressants (e.g., lithium). Use of certain ARBs can prevent these medications from being removed from the body by the kidneys. Therefore, the risk of side effects or overdose may be greater in patients taking ARBs.

  • Some antibiotics (e.g., trimethoprim, rifampicin, fluconazole).

  • Barbiturates. Use of ARBs may increase the depressant effects of these medications.

  • Over-the-counter (OTC) medications that increase blood pressure. These include (but are not limited to) diet pills and medications used to treat asthma, flu, colds, cough, sinus problems or hay fever.

  • Grapefruit juice. Grapefruit juice interferes with the liver’s ability to rid the body of some substances. This could lead to a build up of ARBs to toxic levels in the body. The exact nature of this risk is not completely understood, but patients taking ARBs may be advised to refrain from drinking grapefruit juice by their physicians.

  • Alcohol. Drinking alcoholic beverages could produce a drop in blood pressure. Patients taking ARBs should consult their physician before drinking alcohol.