Drug interactions
Diflunisal + Sacubitril / valsartan
Severity: Moderate
Diflunisal 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
NSAIDs such as diflunisal can blunt the blood pressure lowering effect of sacubitril/valsartan. They may also worsen renal function, especially in elderly or volume-depleted patients, and can add to the risk of hyperkalemia.
What this interaction means in plain words
Diflunisal 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 glomerular perfusion, which combines with angiotensin receptor blockade to impair filtration and reduce natriuresis.
What to do
Monitor blood pressure, serum creatinine and potassium after starting or changing the NSAID. Keep the patient hydrated and use the lowest effective NSAID dose for the shortest time, or choose a non-NSAID analgesic.
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
Frequently asked questions
Can I take Diflunisal with Sacubitril / valsartan?
MediHelp rates the interaction as moderate. Diflunisal 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. NSAIDs such as diflunisal can blunt the blood pressure lowering effect of sacubitril/valsartan. They may also worsen renal function, especially in elderly or volume-depleted patients, and can add to the risk of hyperkalemia.
How serious is the interaction between Diflunisal 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. Keep the patient hydrated and use the lowest effective NSAID dose for the shortest time, or choose a non-NSAID analgesic.
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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