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Hyperkalemia, particularly when coadministered with potassium-sparing diuretics, potassium supplements, or salt substitutes; concurrent therapy with hydrochlorothiazide may reduce the frequency of this effect. Dual blockade of the renin angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for renal function changes including acute renal failure compared to monotherapy; closely monitor blood pressure. Hypotension may occur in patients who are salt or volume depleted correct the volume order benicar hct especially in patients receiving high dose diuretics. Hydrochlorothiazide can cause hypokalemia and hyponatremia; hypomagnesemia can result in hypokalemia which appears difficult to treat despite potassium repletion. Hyperuricemia may occur or gout may be precipitated in certain patients receiving thiazide therapy.

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