Drug interactions
Hydrochlorothiazide-losartan + Parecoxib
Severity: Moderate
Hydrochlorothiazide-losartan 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
NSAIDs such as parecoxib can blunt the antihypertensive effect of ARBs and diuretics through reduced renal prostaglandin synthesis. Together with a diuretic and an ARB they raise the risk of acute kidney injury, especially with volume depletion, and may cause hyperkalemia.
What this interaction means in plain words
Hydrochlorothiazide-losartan 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
COX-2 inhibition reduces renal prostaglandins, causing sodium retention and reduced glomerular perfusion when combined with ARB and diuretic.
What to do
Ensure adequate hydration and monitor blood pressure, serum creatinine and potassium; use the lowest effective parecoxib 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-losartan
- Aliskiren + Hydrochlorothiazide-losartan Contraindicated
- Dofetilide + Hydrochlorothiazide-losartan Contraindicated
- Hydrochlorothiazide-losartan + Sparsentan Contraindicated
- Aceclofenac + Hydrochlorothiazide-losartan Major
- Aldesleukin + Hydrochlorothiazide-losartan Major
- Amifostine + Hydrochlorothiazide-losartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-losartan with Parecoxib?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-losartan 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. NSAIDs such as parecoxib can blunt the antihypertensive effect of ARBs and diuretics through reduced renal prostaglandin synthesis. Together with a diuretic and an ARB they raise the risk of acute kidney injury, especially with volume depletion, and may cause hyperkalemia.
How serious is the interaction between Hydrochlorothiazide-losartan 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: Ensure adequate hydration and monitor blood pressure, serum creatinine and potassium; use the lowest effective parecoxib dose for the shortest time.
What other medicines interact with Hydrochlorothiazide-losartan?
MediHelp also lists interactions of Hydrochlorothiazide-losartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-losartan page.
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