Drug interactions
Diclofenac + Sacubitril / valsartan
Severity: Moderate
Diclofenac and Sacubitril / valsartan: 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 blood pressure lowering effect of sacubitril/valsartan and can impair kidney function, particularly in older patients or those who are volume depleted. Potassium may also rise because both drugs can reduce potassium excretion.
What this interaction means in plain words
Diclofenac and Sacubitril / valsartan 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.
Why it happens
NSAID inhibition of renal vasodilatory prostaglandins reduces renal perfusion and sodium excretion, opposing angiotensin receptor blockade and adding to hyperkalemia and renal risk.
What to do
Monitor blood pressure, serum creatinine and potassium after starting or changing the NSAID, and keep NSAID use as short and low-dose as possible. Prefer paracetamol for analgesia in patients who are elderly, dehydrated or have renal impairment.
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 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 Sacubitril / valsartan?
MediHelp rates the interaction as moderate. Diclofenac and Sacubitril / valsartan 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 blood pressure lowering effect of sacubitril/valsartan and can impair kidney function, particularly in older patients or those who are volume depleted. Potassium may also rise because both drugs can reduce potassium excretion.
How serious is the interaction between Diclofenac and Sacubitril / valsartan?
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, serum creatinine and potassium after starting or changing the NSAID, and keep NSAID use as short and low-dose as possible. Prefer paracetamol for analgesia in patients who are elderly, dehydrated or have renal impairment.
What other medicines interact with Diclofenac?
MediHelp also lists interactions of Diclofenac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Diclofenac page.
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