Drug interactions
Candesartan-hydrochlorothiazide + Parecoxib
Severity: Moderate
Candesartan-hydrochlorothiazide and Parecoxib: moderate 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
Parecoxib, an NSAID prodrug of valdecoxib, can blunt the blood pressure lowering of candesartan and hydrochlorothiazide. Together with an ARB and a diuretic, it raises the risk of acute kidney injury, particularly in elderly or volume-depleted patients, and may cause hyperkalemia.
What this interaction means in plain words
Candesartan-hydrochlorothiazide and Parecoxib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Inhibition of vasodilatory renal prostaglandins reduces renal perfusion and sodium excretion, which opposes antihypertensive effects and compounds the hemodynamic renal effects of ARB and diuretic.
What to do
Ensure adequate hydration and monitor blood pressure, serum creatinine and potassium after starting or changing parecoxib. Use the shortest possible course or an alternative analgesic in patients at high renal risk.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Frequently asked questions
Can I take Candesartan-hydrochlorothiazide with Parecoxib?
MediHelp rates the interaction as moderate. Candesartan-hydrochlorothiazide and Parecoxib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Parecoxib, an NSAID prodrug of valdecoxib, can blunt the blood pressure lowering of candesartan and hydrochlorothiazide. Together with an ARB and a diuretic, it raises the risk of acute kidney injury, particularly in elderly or volume-depleted patients, and may cause hyperkalemia.
How serious is the interaction between Candesartan-hydrochlorothiazide and Parecoxib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Ensure adequate hydration and monitor blood pressure, serum creatinine and potassium after starting or changing parecoxib. Use the shortest possible course or an alternative analgesic in patients at high renal risk.
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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