Drug interactions
Diclofenac + Hydrochlorothiazide-lisinopril
Severity: Major
Diclofenac and Hydrochlorothiazide-lisinopril: 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
NSAIDs such as diclofenac can blunt the antihypertensive effect of the ACE inhibitor and thiazide in this combination. Together with a diuretic and ACE inhibitor they raise the risk of acute kidney injury, particularly in volume-depleted, elderly or renally impaired patients, and can cause hyperkalemia.
What this interaction means in plain words
Diclofenac and Hydrochlorothiazide-lisinopril 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; Hydrochlorothiazide-lisinopril belongs to Cardiovascular.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal blood flow, sodium excretion and afferent arteriolar dilation, which opposes diuretic and ACE inhibitor effects and impairs glomerular filtration.
What to do
Avoid regular NSAID use where possible, or use the lowest dose for the shortest time while monitoring blood pressure, serum creatinine and potassium. Ensure adequate hydration and consider paracetamol as an alternative.
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?
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References
Other interactions of Hydrochlorothiazide-lisinopril
- Dofetilide + Hydrochlorothiazide-lisinopril Contraindicated
- Hydrochlorothiazide-lisinopril + Sacubitril / valsartan Contraindicated
- Amifostine + Hydrochlorothiazide-lisinopril Major
- Amiloride + Hydrochlorothiazide-lisinopril Major
- Benazepril + Hydrochlorothiazide-lisinopril Major
- Bendroflumethiazide + Hydrochlorothiazide-lisinopril 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-lisinopril?
MediHelp rates the interaction as major. Diclofenac and Hydrochlorothiazide-lisinopril 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 diclofenac can blunt the antihypertensive effect of the ACE inhibitor and thiazide in this combination. Together with a diuretic and ACE inhibitor they raise the risk of acute kidney injury, particularly in volume-depleted, elderly or renally impaired patients, and can cause hyperkalemia.
How serious is the interaction between Diclofenac and Hydrochlorothiazide-lisinopril?
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 while monitoring blood pressure, serum creatinine and potassium. Ensure adequate hydration and consider paracetamol as an alternative.
What other medicines interact with Hydrochlorothiazide-lisinopril?
MediHelp also lists interactions of Hydrochlorothiazide-lisinopril with, for example, Dofetilide, Sacubitril / valsartan, Amifostine. The full list is on the Hydrochlorothiazide-lisinopril page.
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