Aliskiren-hydrochlorothiazide

Do not use potassium supplements or salt substitutes while you are taking this medicine, unless your doctor has told you to.

Avoid taking this medicine with a high-fat meal, which can make it harder for your body to absorb aliskiren.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of hydrochlorothiazide and aliskiren.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with hydrochlorothiazide and aliskiren, especially:

• antifungal medicine;
• any heart or blood pressure medicines;
• a barbiturate--amobarbital, phenobarbital, secobarbital and others;
• a blood thinner (warfarin, Coumadin, Jantoven);
• cholesterol medicine--atorvastatin (Lipitor), cholestyramine or colestipol;
• cyclosporine;
• a diuretic or "water pill";
• insulin or oral diabetes medicine;
• lithium;
• a potassium supplement such as K-Dur, Klor-Con;
• salt substitutes that contain potassium; 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 interact with hydrochlorothiazide and aliskiren, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Tell your doctor about all your medical conditions, including whether you:

• have kidney problems
• are pregnant or planning to become pregnant. 
• have any allergies or asthma
• have liver problems
• have systemic lupus erythematosus (SLE). Aliskiren/hydrochlorothiazide can make your SLE active or worse.
• have ever had a reaction called angioedema, to an ACE inhibitor medicine. Angioedema causes swelling of the face, lips, tongue, throat, arms and legs, and may cause difficulty breathing.
• are breast-feeding. It is not known if aliskiren/hydrochlorothiazide passes into your breast milk.

Tell your doctor about all the medicines you take including prescription and nonprescription medicines, vitamins and herbal supplements.

• Take aliskiren/hydrochlorothiazide exactly as prescribed by your doctor. It is important to take aliskiren/hydrochlorothiazide every day to control your blood pressure.
• Take aliskiren/hydrochlorothiazide once each day, about the same time each day.
• Take aliskiren/hydrochlorothiazide the same way everyday, either with or without a meal.
• Your doctor may change your dose of aliskiren/hydrochlorothiazide if needed.
• If you miss a dose of aliskiren/hydrochlorothiazide, take it as soon as you remember. If it is close to your next dose, do not take the missed dose. Just take the next dose at your regular time.
• If you take too much aliskiren/hydrochlorothiazide, call your doctor or a Poison Control Center, or go to the nearest hospital emergency room.

If you take too much aliskiren/hydrochlorothiazide, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If aliskiren/hydrochlorothiazide is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

WARNING: FETAL TOXICITY

• When pregnancy is detected, discontinue aliskiren/hydrochlorothiazide as soon as possible. 
• Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.