Linked to indapamide: May decrease urinary lithium excretion. Increased risk of ventricular arrhythmias w/ torsades de pointes-inducing drugs eg, quinidine, hydroquinidine, disopyramide, amiodarone, sotalol, ibutilide, dofetilide, ibutilide; phenothiazine & benzamide antipsychotics; bepridil, cisapride, diphemanil; erythromycin IV, halofantrine, mizolastine, pentamidine, sparfloxacin, moxifloxacin, vincamine IV. Possible reduction of antihypertensive effect w/ NSAIDs. (systemic route) including COX-2 selective inhibitors, high dose salicylic acid (≥3 g/day). Risk of sudden hypotension &/or acute renal failure when treatment w/ ACE inhibitors. Increased risk of hypokalemia w/ other compd causing hypokalemia eg, amphotericin B (IV), gluco- & mineralo-corticoids (systemic route), tetracosactide, stimulant laxatives. Hypokalemia predisposing to the toxic effects of digitalis. Increased antihypertensive effect w/ baclofen. May increase incidence of hypersensitivity reactions to allopurinol. May cause hypokalemia or hyperkalemia w/ K-sparing diuretics (amiloride, spironolactone, triamterene). May increase risk of metformin-induced lactic acidosis. Increased risk of acute renal failure w/ large doses of iodinated contrast media. Increased risk of orthostatic hypotension w/ imipramine-like antidepressants, neuroleptics. Risk of hypercalcemia w/ Ca (salts). Risk of increased plasma creatinine w/ ciclosporine, tacrolimus. Decreased antihypertensive effect corticosteroids, tetracosactide (systemic route). Linked to indapamide: Risk of hyperkalemia w/ dantrolene (infusion). Increased BP-lowering effects w/ grapefruit or grapefruit juice. Increased amlodipine exposure w/ strong or moderate CYP3A4 inhibitors (protease inhibitors, azole antifungals, macrolides eg, erythromycin or clarithromycin, verapamil or diltiazem). Lowered plasma conc of amlodipine w/ CYP3A4 inducers (eg, rifampicin, Hypericum perforatum
). Added BP-lowering effects w/ other medicinal products. Risk of increase in tacrolimus blood levels. May increase exposure of simvastatin.