hydrochlorothiazide and aliskiren

What is the most important information I should know about hydrochlorothiazide and aliskiren?

If you have diabetes, do not use hydrochlorothiazide and aliskiren together with certain heart or blood pressure medicines (such as Accupril, Benicar, Capoten, Cozaar, Diovan, Lotensin, Mavik, Prinivil, Vasotec, any many others).

What is hydrochlorothiazide and aliskiren?

Hydrochlorothiazide is a thiazide diuretic (water pill). Aliskiren is an anti-hypertensive (blood pressure lowering) medicine.

Hydrochlorothiazide and aliskiren is a combination medicine used to treat high blood pressure (hypertension).

Hydrochlorothiazide and aliskiren may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking hydrochlorothiazide and aliskiren?

• you are unable to urinate; or
• you are allergic to sulfa drugs.

If you have diabetes, you should not use hydrochlorothiazide and aliskiren together with certain heart or blood pressure medicines, such as:

• azilsartan (Edarbi, Edarbyclor), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro, Avalide), losartan (Cozaar, Hyzaar), olmesartan (Azar, Benicar), valsartan (Diovan, Exforge, Tribenzor), telmisartan (Micardis); or
• benazepril (Lotensin), captopril (Capoten, Capozide), enalapril (Vasotec, Vasoretic), fosinopril (Monopril), lisinopril (Prinivil, Zestoretic, Zestril), moexipril (Uniretic, Univasc), perindopril (Aceon), quinapril (Accupril, Accuretic), ramipril (Altace), or trandolapril (Mavik, Tarka).

You may also need to avoid taking these medicines with hydrochlorothiazide and aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• kidney disease;
• liver disease;
• low or high levels of potassium in your blood;
• asthma or allergies;
• systemic lupus erythematosus (SLE);
• glaucoma;
• gout;
• diabetes; or
• an allergy to penicillin.

How should I take hydrochlorothiazide and aliskiren?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take this medicine with or without food, but take it the same way every time. Avoid taking this medicine with a high-fat meal, which can make it harder for your body to absorb aliskiren.

It may take up to 4 weeks before your blood pressure improves. Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Your blood pressure will need to be checked often.

Your doctor may also check your skin because hydrochlorothiazide can increase your risk of developing non-melanoma skin cancer. Ask your doctor about skin symptoms to watch for.

If you need surgery or medical tests, tell the surgeon ahead of time that you are using hydrochlorothiazide and aliskiren. You may need to stop using the medicine for a short time.

Keep the tablets in their original container, along with the packet or canister of moisture-absorbing preservative.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

What should I avoid while taking hydrochlorothiazide and aliskiren?

What are the possible side effects of hydrochlorothiazide and aliskiren?

• a light-headed feeling, like you might pass out;
• little or no urination;
• eye pain, vision problems;
• high potassium level --nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement;
• low potassium level --leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling;
• low sodium level --headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady; or
• lupus-like symptoms --muscle or joint pain, fever, and a rash or patchy skin color that worsens in sunlight.

Common side effects may include:

• dizziness, tired feeling;
• high potassium;
• cough;
• joint pain;
• diarrhea; or
• flu symptoms (fever, chills, body aches).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect hydrochlorothiazide and aliskiren?

If you take cholestyramine or colestipol, take your hydrochlorothiazide and aliskiren dose 4 hours before or 4 hours after you take the other medicine.

Tell your doctor about all your other medicines, especially:

• cyclosporine;
• lithium;
• any heart or blood pressure medicines;
• a diuretic or "water pill";
• insulin or oral diabetes medicine;
• a potassium supplement such as K-Dur, Klor-Con;
• salt substitutes that contain potassium;
• antifungal medicine --itraconazole, ketoconazole;
• cholesterol medication --atorvastatin, cholestyramine, colestipol, simvastatin, Lipitor, Vytorin, Zocor; or
• NSAIDs (nonsteroidal anti-inflammatory drugs) --aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect hydrochlorothiazide and aliskiren, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about hydrochlorothiazide and aliskiren.