Drug interactions
Candesartan-hydrochlorothiazide + Ibuprofen
Severity: Major
Candesartan-hydrochlorothiazide and Ibuprofen: 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
Ibuprofen can weaken the antihypertensive effect of candesartan and hydrochlorothiazide and, together with an ARB and a diuretic, increases the risk of acute kidney injury. This is most relevant in older, dehydrated or renally impaired patients, and hyperkalemia may also occur.
What this interaction means in plain words
Candesartan-hydrochlorothiazide and Ibuprofen 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.
Candesartan-hydrochlorothiazide belongs to Cardiovascular; Ibuprofen belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandins reduces renal perfusion and sodium excretion, counteracting the antihypertensive agents and adding hemodynamic stress to RAAS blockade plus diuresis.
What to do
Prefer paracetamol or non-systemic options where possible. If ibuprofen is needed, use the lowest dose for the shortest time and 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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Other interactions of Candesartan-hydrochlorothiazide
- Aliskiren + Candesartan-hydrochlorothiazide Contraindicated
- Candesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Candesartan-hydrochlorothiazide + Sparsentan Contraindicated
- Acemetacin + Candesartan-hydrochlorothiazide Major
- Amifostine + Candesartan-hydrochlorothiazide Major
- Amiloride + Candesartan-hydrochlorothiazide Major
Other interactions of Ibuprofen
- Ibuprofen + Ketorolac Contraindicated
- Ibuprofen + Ketorolac intranasal Contraindicated
- Acemetacin + Ibuprofen Major
- Alteplase + Ibuprofen Major
- Amiloride + Ibuprofen Major
- Apixaban + Ibuprofen Major
Frequently asked questions
Can I take Candesartan-hydrochlorothiazide with Ibuprofen?
MediHelp rates the interaction as major. Candesartan-hydrochlorothiazide and Ibuprofen 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. Ibuprofen can weaken the antihypertensive effect of candesartan and hydrochlorothiazide and, together with an ARB and a diuretic, increases the risk of acute kidney injury. This is most relevant in older, dehydrated or renally impaired patients, and hyperkalemia may also occur.
How serious is the interaction between Candesartan-hydrochlorothiazide and Ibuprofen?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer paracetamol or non-systemic options where possible. If ibuprofen is needed, use the lowest dose for the shortest time and monitor blood pressure, creatinine and potassium.
What other medicines interact with Candesartan-hydrochlorothiazide?
MediHelp also lists interactions of Candesartan-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Candesartan-hydrochlorothiazide page.
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