Drug interactions
Diclofenac + Eprosartan-hydrochlorothiazide
Severity: Major
Diclofenac and Eprosartan-hydrochlorothiazide: major interaction.
Last updated Sources: US FDA label
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
Diclofenac can reduce the antihypertensive effect of eprosartan and hydrochlorothiazide. Combining an NSAID with a diuretic and an angiotensin receptor blocker (the so-called triple whammy) increases the risk of acute kidney injury and hyperkalemia, especially in elderly or dehydrated patients.
What this interaction means in plain words
Diclofenac and Eprosartan-hydrochlorothiazide 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.
Diclofenac belongs to Musculoskeletal; Eprosartan-hydrochlorothiazide belongs to Cardiovascular.
Why it happens
NSAID inhibition of renal prostaglandins causes sodium retention and reduces renal blood flow, opposing antihypertensive effects while removing compensatory afferent dilation during ARB and diuretic therapy.
What to do
Avoid regular NSAID use where possible, or use the lowest dose for the shortest time with adequate hydration. Monitor blood pressure, creatinine and potassium after starting.
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 Diclofenac and Eprosartan-hydrochlorothiazide, 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.
References
Other interactions of Eprosartan-hydrochlorothiazide
- Aliskiren + Eprosartan-hydrochlorothiazide Contraindicated
- Dofetilide + Eprosartan-hydrochlorothiazide Contraindicated
- Eprosartan-hydrochlorothiazide + Sparsentan Contraindicated
- Aceclofenac + Eprosartan-hydrochlorothiazide Major
- Aldesleukin + Eprosartan-hydrochlorothiazide Major
- Amifostine + Eprosartan-hydrochlorothiazide Major
Other interactions of Diclofenac
- Diclofenac + Ketorolac Contraindicated
- Diclofenac + Ketorolac intranasal Contraindicated
- Aceclofenac + Diclofenac Major
- Acemetacin + Diclofenac Major
- Alteplase + Diclofenac Major
- Amiloride + Diclofenac Major
Frequently asked questions
Can I take Diclofenac with Eprosartan-hydrochlorothiazide?
MediHelp rates the interaction as major. Diclofenac and Eprosartan-hydrochlorothiazide 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. Diclofenac can reduce the antihypertensive effect of eprosartan and hydrochlorothiazide. Combining an NSAID with a diuretic and an angiotensin receptor blocker (the so-called triple whammy) increases the risk of acute kidney injury and hyperkalemia, especially in elderly or dehydrated patients.
How serious is the interaction between Diclofenac and Eprosartan-hydrochlorothiazide?
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 where possible, or use the lowest dose for the shortest time with adequate hydration. Monitor blood pressure, creatinine and potassium after starting.
What other medicines interact with Eprosartan-hydrochlorothiazide?
MediHelp also lists interactions of Eprosartan-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Eprosartan-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.
