Drug interactions
Diclofenac + Hydrochlorothiazide-olmesartan
Severity: Major
Diclofenac and Hydrochlorothiazide-olmesartan: 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 reduce renal prostaglandin synthesis, which blunts the antihypertensive effect of olmesartan and hydrochlorothiazide. In volume-depleted or elderly patients, the combination of an NSAID, ARB and diuretic can cause acute kidney injury and hyperkalemia.
What this interaction means in plain words
Diclofenac and Hydrochlorothiazide-olmesartan 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-olmesartan belongs to Cardiovascular.
Why it happens
Prostaglandin inhibition reduces renal perfusion and sodium excretion, and combined with ARB-mediated efferent dilation impairs glomerular filtration.
What to do
Avoid regular NSAID use where possible, or use the lowest dose for the shortest time while maintaining 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?
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References
Other interactions of Hydrochlorothiazide-olmesartan
- Aliskiren + Hydrochlorothiazide-olmesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-olmesartan Contraindicated
- Hydrochlorothiazide-olmesartan + Sparsentan Contraindicated
- Acemetacin + Hydrochlorothiazide-olmesartan Major
- Amifostine + Hydrochlorothiazide-olmesartan Major
- Amiloride + Hydrochlorothiazide-olmesartan 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-olmesartan?
MediHelp rates the interaction as major. Diclofenac and Hydrochlorothiazide-olmesartan 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 reduce renal prostaglandin synthesis, which blunts the antihypertensive effect of olmesartan and hydrochlorothiazide. In volume-depleted or elderly patients, the combination of an NSAID, ARB and diuretic can cause acute kidney injury and hyperkalemia.
How serious is the interaction between Diclofenac and Hydrochlorothiazide-olmesartan?
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 maintaining hydration. Monitor blood pressure, creatinine and potassium after starting.
What other medicines interact with Hydrochlorothiazide-olmesartan?
MediHelp also lists interactions of Hydrochlorothiazide-olmesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-olmesartan page.
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