Drug interactions
Hydrochlorothiazide-irbesartan + Parecoxib
Severity: Moderate
Hydrochlorothiazide-irbesartan and Parecoxib: 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
Parecoxib, an NSAID prodrug of valdecoxib, can blunt the antihypertensive effect of irbesartan and hydrochlorothiazide. In combination with an ARB and a diuretic it can also impair renal function, especially in elderly or volume-depleted patients, and may raise potassium.
What this interaction means in plain words
Hydrochlorothiazide-irbesartan and Parecoxib 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
Inhibition of renal prostaglandin synthesis reduces renal blood flow, sodium excretion and diuretic/ARB efficacy, and adds to the risk of acute kidney injury when combined with RAAS blockade and diuresis.
What to do
Monitor blood pressure, serum creatinine and potassium after starting parecoxib, and ensure adequate hydration. Use the lowest effective 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 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
Frequently asked questions
Can I take Hydrochlorothiazide-irbesartan with Parecoxib?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-irbesartan and Parecoxib 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. Parecoxib, an NSAID prodrug of valdecoxib, can blunt the antihypertensive effect of irbesartan and hydrochlorothiazide. In combination with an ARB and a diuretic it can also impair renal function, especially in elderly or volume-depleted patients, and may raise potassium.
How serious is the interaction between Hydrochlorothiazide-irbesartan and Parecoxib?
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 parecoxib, and ensure adequate hydration. Use the lowest effective dose for the shortest time.
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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