Drug interactions
Diflunisal + Hydrochlorothiazide-olmesartan
Severity: Major
Diflunisal 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
Diflunisal can weaken the blood pressure lowering effect of olmesartan and hydrochlorothiazide. In elderly or volume-depleted patients the triple combination of NSAID, ARB and diuretic may impair kidney function and raise potassium.
What this interaction means in plain words
Diflunisal 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.
Diflunisal belongs to Musculoskeletal; Hydrochlorothiazide-olmesartan belongs to Cardiovascular.
Why it happens
NSAID inhibition of vasodilatory renal prostaglandins reduces glomerular perfusion and sodium excretion, adding to ARB effects on glomerular filtration.
What to do
Prefer a non-NSAID analgesic such as paracetamol when feasible. If used, ensure hydration and monitor blood pressure, creatinine and potassium.
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 Diflunisal
- Diflunisal + Ketorolac Contraindicated
- Diflunisal + Ketorolac intranasal Contraindicated
- Acemetacin + Diflunisal Major
- Acetazolamide + Diflunisal Major
- Alteplase + Diflunisal Major
- Amiloride + Diflunisal Major
Frequently asked questions
Can I take Diflunisal with Hydrochlorothiazide-olmesartan?
MediHelp rates the interaction as major. Diflunisal 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. Diflunisal can weaken the blood pressure lowering effect of olmesartan and hydrochlorothiazide. In elderly or volume-depleted patients the triple combination of NSAID, ARB and diuretic may impair kidney function and raise potassium.
How serious is the interaction between Diflunisal 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: Prefer a non-NSAID analgesic such as paracetamol when feasible. If used, ensure hydration and monitor blood pressure, creatinine and potassium.
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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