Drug interactions
Hydrochlorothiazide-losartan + Piroxicam
Severity: Moderate
Hydrochlorothiazide-losartan 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 blunt the antihypertensive effect of losartan and hydrochlorothiazide. With an ARB and a diuretic it increases the risk of acute kidney injury and hyperkalemia, especially in elderly or volume depleted patients.
What this interaction means in plain words
Hydrochlorothiazide-losartan 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-losartan belongs to Cardiovascular; Piroxicam belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal blood flow and sodium excretion, opposing ARB and diuretic effects.
What to do
Monitor blood pressure, serum creatinine and potassium, and ensure hydration. Use the lowest effective NSAID dose briefly or switch to an alternative analgesic.
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
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-losartan with Piroxicam?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-losartan 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 blunt the antihypertensive effect of losartan and hydrochlorothiazide. With an ARB and a diuretic it increases the risk of acute kidney injury and hyperkalemia, especially in elderly or volume depleted patients.
How serious is the interaction between Hydrochlorothiazide-losartan 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: Monitor blood pressure, serum creatinine and potassium, and ensure hydration. Use the lowest effective NSAID dose briefly or switch to an alternative analgesic.
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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