Drug interactions
Amlodipine-hydrochlorothiazide-valsartan + Sulindac
Severity: Major
Amlodipine-hydrochlorothiazide-valsartan and Sulindac: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
NSAIDs such as sulindac blunt the antihypertensive effect of valsartan and hydrochlorothiazide by inhibiting vasodilatory renal prostaglandins and promoting sodium and water retention. The combination of NSAID, ARB and diuretic raises the risk of acute kidney injury, particularly in elderly or volume-depleted patients, and may increase serum potassium.
What this interaction means in plain words
Amlodipine-hydrochlorothiazide-valsartan and Sulindac can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amlodipine-hydrochlorothiazide-valsartan belongs to Cardiovascular; Sulindac belongs to Musculoskeletal.
Why it happens
Prostaglandin inhibition reduces renal perfusion and natriuresis, antagonizing antihypertensives and compounding renal hemodynamic effects of ARB and diuretic.
What to do
Avoid regular NSAID use where possible; use the lowest dose for the shortest time and ensure adequate hydration. Monitor blood pressure, creatinine and potassium after starting.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amlodipine-hydrochlorothiazide-valsartan
- Aliskiren + Amlodipine-hydrochlorothiazide-valsartan Contraindicated
- Amlodipine-hydrochlorothiazide-valsartan + Dofetilide Contraindicated
- Amlodipine-hydrochlorothiazide-valsartan + Sparsentan Contraindicated
- Aceclofenac + Amlodipine-hydrochlorothiazide-valsartan Major
- Aldesleukin + Amlodipine-hydrochlorothiazide-valsartan Major
- Amifostine + Amlodipine-hydrochlorothiazide-valsartan Major
Other interactions of Sulindac
- Ketorolac intranasal + Sulindac Contraindicated
- Ketorolac + Sulindac Contraindicated
- Aceclofenac + Sulindac Major
- Acetylsalicylic acid + Sulindac Major
- Alteplase + Sulindac Major
- Amiloride + Sulindac Major
Frequently asked questions
Can I take Amlodipine-hydrochlorothiazide-valsartan with Sulindac?
MediHelp rates the interaction as major. Amlodipine-hydrochlorothiazide-valsartan and Sulindac can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. NSAIDs such as sulindac blunt the antihypertensive effect of valsartan and hydrochlorothiazide by inhibiting vasodilatory renal prostaglandins and promoting sodium and water retention. The combination of NSAID, ARB and diuretic raises the risk of acute kidney injury, particularly in elderly or volume-depleted patients, and may increase serum potassium.
How serious is the interaction between Amlodipine-hydrochlorothiazide-valsartan and Sulindac?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid regular NSAID use where possible; use the lowest dose for the shortest time and ensure adequate hydration. Monitor blood pressure, creatinine and potassium after starting.
What other medicines interact with Amlodipine-hydrochlorothiazide-valsartan?
MediHelp also lists interactions of Amlodipine-hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Amlodipine-hydrochlorothiazide-valsartan page.
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