Drug interactions
Hydrochlorothiazide-irbesartan + Piroxicam
Severity: Moderate
Hydrochlorothiazide-irbesartan and Piroxicam: 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
Piroxicam can reduce the blood pressure effect of irbesartan and hydrochlorothiazide. In combination with an ARB and a diuretic it increases the risk of acute kidney injury and hyperkalemia, especially in older or dehydrated patients.
What this interaction means in plain words
Hydrochlorothiazide-irbesartan and Piroxicam 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; Piroxicam belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis causes sodium retention and decreased renal perfusion, which compromises filtration when combined with ARB and diuretic effects.
What to do
Limit NSAID dose and duration and ensure adequate hydration. Monitor blood pressure, serum creatinine and potassium after starting.
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 Piroxicam
- Ketorolac intranasal + Piroxicam Contraindicated
- Ketorolac + Piroxicam Contraindicated
- Aceclofenac + Piroxicam Major
- Acemetacin + Piroxicam Major
- Acetylsalicylic acid + Piroxicam Major
- Alteplase + Piroxicam Major
Frequently asked questions
Can I take Hydrochlorothiazide-irbesartan with Piroxicam?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-irbesartan and Piroxicam 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. Piroxicam can reduce the blood pressure effect of irbesartan and hydrochlorothiazide. In combination with an ARB and a diuretic it increases the risk of acute kidney injury and hyperkalemia, especially in older or dehydrated patients.
How serious is the interaction between Hydrochlorothiazide-irbesartan and Piroxicam?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit NSAID dose and duration and ensure adequate hydration. Monitor blood pressure, serum creatinine and potassium after starting.
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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