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2014年4月11日,欧洲药品管理局(EMA)发布警告:避免联用两种在肾素-血管紧张素-醛固酮系统(RAS)有独立作用的药物。作用于RAS系统的几类药物包括血管紧张素受体拮抗剂(ARB)、血管紧张素转换酶抑制剂(ACEI)和直接肾素抑制剂。特别是糖尿病肾病的患者,不应联合使用ARB和ACEI。EMA同时指出如果出现必须联用双抑制药物的情况时,必须严格检测肾功能、水钠平衡和血压。ARBs类的坎替沙坦或缬沙坦可作为已经使用ACEI类药物的心衰病人的一项附加治疗,而严格禁止阿利克仑联用ACEI或ARBs治疗
On April 11, 2014, the European Medicines Agency (EMA) issued a warning: Avoid combining two drugs that have an independent effect on the renin-angiotensin-aldosterone system (RAS). Several classes of drugs that act on the RAS system include angiotensin receptor blockers (ARBs), angiotensin converting enzyme inhibitors (ACEIs), and direct renin inhibitors. In particular, patients with diabetic nephropathy should not be combined with ARB and ACEI. EMA also pointed out that in the event of a combination of dual inhibitory drugs, renal function, water-sodium balance, and blood pressure must be closely monitored. Canasartan or valsartan in the ARBs category is an additional treatment for patients with heart failure who have already taken ACEIs, and the combination of aliskiren and ACEI or ARBs is strictly forbidden