Drug interactions
Azilsartan-chlorthalidone + Sulindac
Severity: Major
Azilsartan-chlorthalidone and Sulindac: major interaction.
Last updated Sources: US FDA label
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
Sulindac may reduce the antihypertensive efficacy of azilsartan and chlorthalidone and, together with an ARB and diuretic, raises the risk of acute kidney injury and hyperkalemia. Risk is highest in elderly or volume-depleted patients. Sulindac may have less renal prostaglandin effect than other NSAIDs but caution still applies.
What this interaction means in plain words
Azilsartan-chlorthalidone 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.
Azilsartan-chlorthalidone belongs to Cardiovascular; Sulindac belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal perfusion and sodium excretion, adding to ARB and diuretic effects on glomerular filtration.
What to do
Avoid if possible or use the lowest dose for the shortest time. Monitor blood pressure, creatinine and potassium and ensure hydration.
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
Other interactions of Azilsartan-chlorthalidone
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 Azilsartan-chlorthalidone with Sulindac?
MediHelp rates the interaction as major. Azilsartan-chlorthalidone 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. Sulindac may reduce the antihypertensive efficacy of azilsartan and chlorthalidone and, together with an ARB and diuretic, raises the risk of acute kidney injury and hyperkalemia. Risk is highest in elderly or volume-depleted patients. Sulindac may have less renal prostaglandin effect than other NSAIDs but caution still applies.
How serious is the interaction between Azilsartan-chlorthalidone 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 if possible or use the lowest dose for the shortest time. Monitor blood pressure, creatinine and potassium and ensure hydration.
What other medicines interact with Azilsartan-chlorthalidone?
MediHelp also lists interactions of Azilsartan-chlorthalidone with, for example, Aliskiren, Sparsentan, Aceclofenac. The full list is on the Azilsartan-chlorthalidone page.
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