Drug interactions
Diclofenac + Hydrochlorothiazide-losartan
Severity: Moderate
Diclofenac 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
Diclofenac inhibits prostaglandin synthesis, which can reduce the antihypertensive effect of losartan and hydrochlorothiazide and raise the risk of acute kidney injury and hyperkalemia, especially in older or volume-depleted patients. The combination of NSAID, ARB and diuretic is a recognized high-risk triple combination for kidney injury.
What this interaction means in plain words
Diclofenac 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.
Diclofenac belongs to Musculoskeletal; Hydrochlorothiazide-losartan belongs to Cardiovascular.
Why it happens
NSAID-induced COX inhibition reduces renal vasodilatory prostaglandins, causing sodium retention and reduced glomerular perfusion under RAAS blockade and diuresis.
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.
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 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-losartan?
MediHelp rates the interaction as moderate. Diclofenac 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. Diclofenac inhibits prostaglandin synthesis, which can reduce the antihypertensive effect of losartan and hydrochlorothiazide and raise the risk of acute kidney injury and hyperkalemia, especially in older or volume-depleted patients. The combination of NSAID, ARB and diuretic is a recognized high-risk triple combination for kidney injury.
How serious is the interaction between Diclofenac 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: Avoid regular NSAID use where possible, or use the lowest dose for the shortest time with adequate hydration. Monitor blood pressure, creatinine and potassium.
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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