Drug interactions
Diflunisal + Metolazone
Severity: Moderate
Diflunisal and Metolazone: 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
NSAIDs can blunt the diuretic and antihypertensive effect of thiazide-like diuretics such as metolazone through sodium and water retention. The combination may also increase the risk of acute kidney injury, especially in volume-depleted or elderly patients.
What this interaction means in plain words
Diflunisal and Metolazone 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.
Diflunisal belongs to Musculoskeletal; Metolazone belongs to Cardiovascular.
Why it happens
NSAID inhibition of renal vasodilatory prostaglandins reduces renal blood flow and promotes sodium retention, opposing diuretic effect.
What to do
Monitor blood pressure, weight, edema and serum creatinine and electrolytes when starting or continuing the combination. Ensure adequate hydration and use the lowest NSAID dose for the shortest time.
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 Diflunisal
- Diflunisal + Ketorolac Contraindicated
- Diflunisal + Ketorolac intranasal Contraindicated
- Acemetacin + Diflunisal Major
- Acetazolamide + Diflunisal Major
- Alteplase + Diflunisal Major
- Amiloride + Diflunisal Major
Other interactions of Metolazone
Frequently asked questions
Can I take Diflunisal with Metolazone?
MediHelp rates the interaction as moderate. Diflunisal and Metolazone 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. NSAIDs can blunt the diuretic and antihypertensive effect of thiazide-like diuretics such as metolazone through sodium and water retention. The combination may also increase the risk of acute kidney injury, especially in volume-depleted or elderly patients.
How serious is the interaction between Diflunisal and Metolazone?
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, weight, edema and serum creatinine and electrolytes when starting or continuing the combination. Ensure adequate hydration and use the lowest NSAID dose for the shortest time.
What other medicines interact with Diflunisal?
MediHelp also lists interactions of Diflunisal with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Diflunisal page.
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