Candesartan and Valsartan risks

Posted , 5 users are following.

This warning is issued to doctors in the BNF:

Concomitant use of drugs affecting the renin-angiotensin system

The MHRA has issued new guidance that combination therapy with two drugs that affect the renin-angiotensin system (ACE inhibitors, angiotensin-II receptor antagonists, and aliskiren) is not recommended due to an increased risk of hyperkalaemia, hypotension, and renal impairment, compared to use of a single drug. There is some evidence that the benefits of combination use of an ACE inhibitor with candesartan or valsartan may outweigh the risks in selected patients with heart failure for whom other treatments are unsuitable, however, the concomitant use of this combination, together with an aldosterone antagonist or a potassium-sparing diuretic is not recommended. For patients currently taking combination therapy, the need for continued combined therapy should be reviewed.


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  • Posted

    Derek, does that just apply to Candesartan and Valsartan as in the headingin the MHRA warning?  Is it a recent warning? 

    If I've read it correctly, I'm very concerned.   I'm on Losartan plus the potassium sparing diuretic, Indapamide,  and I have reduced kidney function.  I am under a renal consultant for my blood pressure but not due to see him until September.  Have only just started the diuretic so now wondering if I should stop it.  Decisions, decisions!

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  • Posted

    Derek. Can you please tell me if the information you gave applies to my husband's prescription for the combination of Losartan and Felodipine for high blood pressure. Fortunately no diuretic .He also takes Pantoprazole and Simvastatin. Quite a cocktail! Thank you.

    Slightly concerned wife

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