Symptomatic hypotension may occur if an angiotensin II receptor antagonist is started in a patient taking high-dose diuretics. Potassium levels may be either increased, decreased or not affected by the concurrent use of these drugs. No clinically relevant pharmacokinetic interactions appear to occur between candesartan, eprosartan, irbesartan, losartan, telmisartan or valsartan, and hydrochlorothiazide, although the bioavailability of hydrochlorothiazide may be modestly reduced.
It has been recommended that the dose of diuretic or angiotensin II receptor antagonist be reduced to avoid hypotension. Initially monitor blood pressure and potassium levels.
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