Drug interactions
Diclofenac + Hydrochlorothiazide-irbesartan
Severity: Moderate
Diclofenac and Hydrochlorothiazide-irbesartan: 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
Diclofenac can reduce the antihypertensive effect of irbesartan and hydrochlorothiazide. In combination with an ARB and a diuretic it increases the risk of acute kidney injury, particularly in elderly or volume-depleted patients, and can cause hyperkalemia.
What this interaction means in plain words
Diclofenac and Hydrochlorothiazide-irbesartan 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.
Diclofenac belongs to Musculoskeletal; Hydrochlorothiazide-irbesartan belongs to Cardiovascular.
Why it happens
NSAID inhibition of renal prostaglandins reduces renal perfusion and sodium excretion, compounding the hemodynamic effects of ARB and diuretic.
What to do
Monitor blood pressure, creatinine and potassium after starting the NSAID, and keep the patient well hydrated. Use the shortest, lowest-dose course or an alternative analgesic.
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-irbesartan
- Aliskiren + Hydrochlorothiazide-irbesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-irbesartan Contraindicated
- Hydrochlorothiazide-irbesartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-irbesartan Major
- Amifostine + Hydrochlorothiazide-irbesartan Major
- Amiloride + Hydrochlorothiazide-irbesartan 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 Hydrochlorothiazide-irbesartan?
MediHelp rates the interaction as moderate. Diclofenac and Hydrochlorothiazide-irbesartan 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. Diclofenac can reduce the antihypertensive effect of irbesartan and hydrochlorothiazide. In combination with an ARB and a diuretic it increases the risk of acute kidney injury, particularly in elderly or volume-depleted patients, and can cause hyperkalemia.
How serious is the interaction between Diclofenac and Hydrochlorothiazide-irbesartan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure, creatinine and potassium after starting the NSAID, and keep the patient well hydrated. Use the shortest, lowest-dose course or an alternative analgesic.
What other medicines interact with Hydrochlorothiazide-irbesartan?
MediHelp also lists interactions of Hydrochlorothiazide-irbesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-irbesartan page.
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