Drug interactions
Candesartan-hydrochlorothiazide + Indomethacin
Severity: Major
Candesartan-hydrochlorothiazide and Indomethacin: 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
Indomethacin can reduce the antihypertensive effect of candesartan and hydrochlorothiazide and substantially raises the risk of acute kidney injury when added to an ARB and diuretic. Hyperkalemia may also develop, especially in older or volume-depleted patients.
What this interaction means in plain words
Candesartan-hydrochlorothiazide and Indomethacin 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; Indomethacin belongs to Musculoskeletal.
Why it happens
NSAID inhibition of vasodilatory renal prostaglandins reduces renal perfusion and sodium excretion, counteracting antihypertensive therapy and compounding the effect of RAAS blockade and diuresis.
What to do
Avoid where possible and choose an alternative analgesic. If used, give 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 Indomethacin
- Indomethacin + Ketorolac Contraindicated
- Indomethacin + Ketorolac intranasal Contraindicated
- Aceclofenac + Indomethacin Major
- Acemetacin + Indomethacin Major
- Acetylsalicylic acid + Indomethacin Major
- Alteplase + Indomethacin Major
Frequently asked questions
Can I take Candesartan-hydrochlorothiazide with Indomethacin?
MediHelp rates the interaction as major. Candesartan-hydrochlorothiazide and Indomethacin 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. Indomethacin can reduce the antihypertensive effect of candesartan and hydrochlorothiazide and substantially raises the risk of acute kidney injury when added to an ARB and diuretic. Hyperkalemia may also develop, especially in older or volume-depleted patients.
How serious is the interaction between Candesartan-hydrochlorothiazide and Indomethacin?
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 where possible and choose an alternative analgesic. If used, give 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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