Losartan × Prednisolone

Prednisolone retains sodium and water via mineralocorticoid effect, blunting the ARB's antihypertensive effect. Both also contribute to hyperkalaemia in CKD.

Return or rise of blood pressure, leg oedema. Weakness, fatigue, paraesthesias, arrhythmia. Symptoms develop at potassium above 5.5 mmol/L; life-threatening above 6.5 mmol/L.

For short prednisolone courses (3–7 days), no specific adjustment needed. For long-term therapy, check BP weekly in the first month. If BP rises, increase losartan or add a thiazide. Potassium and creatinine every 2 weeks.