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Information update

New warnings regarding blood pressure drugs

Starting date:
February 4, 2014
Posting date:
February 4, 2014
Type of communication:
Information Update
Source of recall:
Health Canada
New safety information
Healthcare Professionals
Identification number:


Health Canada wishes to inform healthcare professionals and patients of the risks associated with combining more than one of the following blood pressure medicines: aliskiren (renin inhibitor), angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs).

Recent studies have demonstrated that any combination of aliskiren, ACEIs or ARBs increases the risks of hypotension (low blood pressure), hyperkalemia (high levels of potassium in the blood) and kidney problems.

Furthermore, aliskiren should not be taken in combination with ACEIs or with ARBs in patients with diabetes or kidney disease due to the additional risks of stroke and syncope (fainting) in these patients.

The product labels have been updated to better reflect the new recommendations regarding the safe use of these medicines.

A list of the products containing aliskiren, ACEIs or ARBs that are currently available in Canada is provided below.

All aliskiren, ACEIs or ARBs containing products available in Canada (as of February 4, 2014)


  • Benazepril
  • Lisinopril
  • Lisinopril-HCTFootnote *
  • Fosinopril
  • Enalapril
  • Enalapril-HCT
  • Enalaprilat
  • Ramipril
  • Ramipril-HCT
  • Quinapril
  • Quinapril-HCT
  • Perindopril
  • Perindopril-indapamide
  • Cilazapril
  • Cilazapril-HCT
  • Captopril
  • Trandolapril
  • Trandolapril-verapamil


  • Valsartan
  • Valsartan-HCT
  • Telmisartan
  • Telmisartan-HCT
  • Telmisartan-amlodipine
  • Irbesartan
  • Irbesartan-HCT
  • Azilsartan medoxomil
  • Azilsartan-chlorthalidone
  • Olmesartan medoxomil
  • Olmesartan-HCT
  • Candesartan
  • Candesartan cilexetil-HCT
  • Candesartan-HCT
  • Losartan
  • Losartan-HCT
  • Eprosartan
  • Eprosartan-HCT

Renin inhibitors

  • Aliskiren
  • Aliskiren-HCT


Footnote *

HCT: hydrochlorothiazide

Return to footnote * referrer

What you should do

  • Talk to a healthcare professional if you have any questions or concerns about your blood pressure medication.
  • You should not stop treatment without consulting your doctor or healthcare professional. If untreated, high blood pressure can cause serious health effects over time.

Report health or safety concerns

To report a side effect to a health product to Health Canada:

  • Call toll-free at 1-866-234-2345
  • Visit Health Canada's Web page on Adverse Reaction Reporting for information on how to report online, by mail or by fax.

Media enquiries

Health Canada

(613) 957-2983

Public enquiries

(613) 957-2991

1-866 225-0709