Drug interactions
Celecoxib + Hydrochlorothiazide-losartan
Severity: Moderate
Celecoxib and Hydrochlorothiazide-losartan: 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
NSAIDs reduce renal prostaglandin synthesis, which can blunt the antihypertensive effect of losartan and hydrochlorothiazide and raise the risk of acute kidney injury and hyperkalemia, particularly in older or volume-depleted patients. This is the so-called triple whammy when a diuretic, an ARB and an NSAID are combined.
What this interaction means in plain words
Celecoxib and Hydrochlorothiazide-losartan 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.
Celecoxib belongs to Musculoskeletal; Hydrochlorothiazide-losartan belongs to Cardiovascular.
Why it happens
COX-2 inhibition reduces vasodilatory prostaglandins, causing sodium retention, reduced renal perfusion and antagonism of antihypertensive effects.
What to do
Use the lowest effective celecoxib dose for the shortest time, and ensure adequate hydration. Monitor blood pressure, creatinine and potassium, or consider an alternative analgesic such as paracetamol.
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 Hydrochlorothiazide-losartan
- Aliskiren + Hydrochlorothiazide-losartan Contraindicated
- Dofetilide + Hydrochlorothiazide-losartan Contraindicated
- Hydrochlorothiazide-losartan + Sparsentan Contraindicated
- Aceclofenac + Hydrochlorothiazide-losartan Major
- Aldesleukin + Hydrochlorothiazide-losartan Major
- Amifostine + Hydrochlorothiazide-losartan Major
Other interactions of Celecoxib
- Celecoxib + Ketorolac Contraindicated
- Celecoxib + Ketorolac intranasal Contraindicated
- Aceclofenac + Celecoxib Major
- Acemetacin + Celecoxib Major
- Amiloride + Celecoxib Major
- Apixaban + Celecoxib Major
Frequently asked questions
Can I take Celecoxib with Hydrochlorothiazide-losartan?
MediHelp rates the interaction as moderate. Celecoxib and Hydrochlorothiazide-losartan 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. NSAIDs reduce renal prostaglandin synthesis, which can blunt the antihypertensive effect of losartan and hydrochlorothiazide and raise the risk of acute kidney injury and hyperkalemia, particularly in older or volume-depleted patients. This is the so-called triple whammy when a diuretic, an ARB and an NSAID are combined.
How serious is the interaction between Celecoxib and Hydrochlorothiazide-losartan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective celecoxib dose for the shortest time, and ensure adequate hydration. Monitor blood pressure, creatinine and potassium, or consider an alternative analgesic such as paracetamol.
What other medicines interact with Hydrochlorothiazide-losartan?
MediHelp also lists interactions of Hydrochlorothiazide-losartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-losartan page.
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