Drug interactions
Hydrochlorothiazide-irbesartan + Naproxen
Severity: Moderate
Hydrochlorothiazide-irbesartan and Naproxen: 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
Naproxen can reduce the blood pressure control achieved with irbesartan and hydrochlorothiazide. With the ARB and diuretic, it also increases the risk of acute kidney injury and hyperkalemia, particularly in elderly, dehydrated or renally impaired patients.
What this interaction means in plain words
Hydrochlorothiazide-irbesartan and Naproxen 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; Naproxen belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis causes sodium and water retention and reduces renal perfusion, impairing glomerular filtration in patients also receiving an ARB and a diuretic.
What to do
Avoid prolonged or high-dose NSAID use and keep the patient well hydrated. Monitor blood pressure, serum creatinine and potassium after starting the NSAID, or choose paracetamol where possible.
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 Naproxen
- Ketorolac intranasal + Naproxen Contraindicated
- Ketorolac + Naproxen Contraindicated
- Aceclofenac + Naproxen Major
- Acemetacin + Naproxen Major
- Acetylsalicylic acid + Naproxen Major
- Alteplase + Naproxen Major
Frequently asked questions
Can I take Hydrochlorothiazide-irbesartan with Naproxen?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-irbesartan and Naproxen 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. Naproxen can reduce the blood pressure control achieved with irbesartan and hydrochlorothiazide. With the ARB and diuretic, it also increases the risk of acute kidney injury and hyperkalemia, particularly in elderly, dehydrated or renally impaired patients.
How serious is the interaction between Hydrochlorothiazide-irbesartan and Naproxen?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid prolonged or high-dose NSAID use and keep the patient well hydrated. Monitor blood pressure, serum creatinine and potassium after starting the NSAID, or choose paracetamol where possible.
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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