Drug interactions
Hydrochlorothiazide-irbesartan + Nabumetone
Severity: Moderate
Hydrochlorothiazide-irbesartan and Nabumetone: 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 antihypertensive effect of angiotensin receptor blockers and thiazides. In patients who are older, volume depleted or have renal impairment, combining an NSAID with an ARB and a diuretic (the so-called triple whammy) raises the risk of acute kidney injury and hyperkalemia.
What this interaction means in plain words
Hydrochlorothiazide-irbesartan and Nabumetone 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.
Hydrochlorothiazide-irbesartan belongs to Cardiovascular; Nabumetone belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces afferent arteriolar dilation and promotes sodium and fluid retention, which impairs glomerular filtration when the efferent tone is lowered by the ARB and volume is reduced by the diuretic.
What to do
Use the lowest effective NSAID dose for the shortest time and ensure adequate hydration. Monitor blood pressure, serum creatinine and potassium, especially in the first weeks; consider paracetamol as an alternative.
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 Hydrochlorothiazide-irbesartan
- Aliskiren + Hydrochlorothiazide-irbesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-irbesartan Contraindicated
- Hydrochlorothiazide-irbesartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-irbesartan Major
- Amifostine + Hydrochlorothiazide-irbesartan Major
- Amiloride + Hydrochlorothiazide-irbesartan Major
Other interactions of Nabumetone
- Ketorolac intranasal + Nabumetone Contraindicated
- Ketorolac + Nabumetone Contraindicated
- Aceclofenac + Nabumetone Major
- Acemetacin + Nabumetone Major
- Acetylsalicylic acid + Nabumetone Major
- Alteplase + Nabumetone Major
Frequently asked questions
Can I take Hydrochlorothiazide-irbesartan with Nabumetone?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-irbesartan and Nabumetone 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 antihypertensive effect of angiotensin receptor blockers and thiazides. In patients who are older, volume depleted or have renal impairment, combining an NSAID with an ARB and a diuretic (the so-called triple whammy) raises the risk of acute kidney injury and hyperkalemia.
How serious is the interaction between Hydrochlorothiazide-irbesartan and Nabumetone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective NSAID dose for the shortest time and ensure adequate hydration. Monitor blood pressure, serum creatinine and potassium, especially in the first weeks; consider paracetamol as an alternative.
What other medicines interact with Hydrochlorothiazide-irbesartan?
MediHelp also lists interactions of Hydrochlorothiazide-irbesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-irbesartan page.
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