Drug interactions
Candesartan-hydrochlorothiazide + Sulindac
Severity: Major
Candesartan-hydrochlorothiazide and Sulindac: 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
NSAIDs such as sulindac can blunt the antihypertensive effect of angiotensin receptor blockers and thiazides. Together with a diuretic and an ARB they raise the risk of acute kidney injury (the triple whammy), especially in volume-depleted or older patients. Hyperkalemia may also occur.
What this interaction means in plain words
Candesartan-hydrochlorothiazide 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.
Candesartan-hydrochlorothiazide belongs to Cardiovascular; Sulindac belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandins reduces renal perfusion and sodium excretion, which opposes antihypertensive effect and increases renal impairment and hyperkalemia risk with RAAS blockade.
What to do
Avoid regular NSAID use if possible, or use the lowest dose for the shortest time with adequate hydration. Monitor blood pressure, serum 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Candesartan-hydrochlorothiazide and Sulindac, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 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 Candesartan-hydrochlorothiazide with Sulindac?
MediHelp rates the interaction as major. Candesartan-hydrochlorothiazide 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. NSAIDs such as sulindac can blunt the antihypertensive effect of angiotensin receptor blockers and thiazides. Together with a diuretic and an ARB they raise the risk of acute kidney injury (the triple whammy), especially in volume-depleted or older patients. Hyperkalemia may also occur.
How serious is the interaction between Candesartan-hydrochlorothiazide 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 regular NSAID use if possible, or use the lowest dose for the shortest time with adequate hydration. Monitor blood pressure, serum 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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
