Drug interactions
Amlodipine-olmesartan-hydrochlorothiazide + Parecoxib
Severity: Major
Amlodipine-olmesartan-hydrochlorothiazide and Parecoxib: major interaction.
Last updated Sources: UK SmPC
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 parecoxib can reduce the antihypertensive effect of ARBs and thiazides. Combined with an ARB and a diuretic, they increase the risk of acute kidney injury, especially with dehydration or in older patients, and may cause hyperkalemia.
What this interaction means in plain words
Amlodipine-olmesartan-hydrochlorothiazide and Parecoxib 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.
Why it happens
Inhibition of renal prostaglandins reduces renal perfusion and sodium excretion, worsening effects of RAAS blockade and diuretics.
What to do
Avoid or limit to the shortest duration with adequate hydration. Monitor blood pressure, creatinine and potassium.
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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References
- Dynastat 40mg Powder and Solvent for Solution for Injection - SmPC sections 4.3/4.5 (class statement: angiotensin II antagonists; "Inhibition of prostaglandins by NSAIDs, including COX-2 inhibitors, may diminish the effect of angiotensin converting enzyme (ACE) inhibitors, angiotensin II an") — electronic medicines compendium (UK SmPC)
Other interactions of Amlodipine-olmesartan-hydrochlorothiazide
- Aliskiren + Amlodipine-olmesartan-hydrochlorothiazide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Sparsentan Contraindicated
- Acemetacin + Amlodipine-olmesartan-hydrochlorothiazide Major
- Aldesleukin + Amlodipine-olmesartan-hydrochlorothiazide Major
- Amifostine + Amlodipine-olmesartan-hydrochlorothiazide Major
Frequently asked questions
Can I take Amlodipine-olmesartan-hydrochlorothiazide with Parecoxib?
MediHelp rates the interaction as major. Amlodipine-olmesartan-hydrochlorothiazide and Parecoxib 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 parecoxib can reduce the antihypertensive effect of ARBs and thiazides. Combined with an ARB and a diuretic, they increase the risk of acute kidney injury, especially with dehydration or in older patients, and may cause hyperkalemia.
How serious is the interaction between Amlodipine-olmesartan-hydrochlorothiazide and Parecoxib?
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 or limit to the shortest duration with adequate hydration. Monitor blood pressure, creatinine and potassium.
What other medicines interact with Amlodipine-olmesartan-hydrochlorothiazide?
MediHelp also lists interactions of Amlodipine-olmesartan-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Amlodipine-olmesartan-hydrochlorothiazide page.
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