Drug interactions
Hydrochlorothiazide-losartan + Salsalate
Severity: Moderate
Hydrochlorothiazide-losartan and Salsalate: 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
Salsalate is an NSAID-type salicylate and can reduce the blood-pressure-lowering effect of losartan and hydrochlorothiazide. Together with an ARB and a diuretic it raises the risk of acute kidney injury, especially in elderly or volume-depleted patients, and may contribute to hyperkalemia.
What this interaction means in plain words
Hydrochlorothiazide-losartan and Salsalate 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 afferent arteriolar dilation and sodium excretion, and combined with angiotensin II blockade and diuretic volume loss this lowers glomerular filtration.
What to do
Monitor blood pressure, serum creatinine and potassium after starting or changing salsalate. Maintain hydration and consider a non-NSAID analgesic such as paracetamol in high-risk patients.
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 Salsalate?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-losartan and Salsalate 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. Salsalate is an NSAID-type salicylate and can reduce the blood-pressure-lowering effect of losartan and hydrochlorothiazide. Together with an ARB and a diuretic it raises the risk of acute kidney injury, especially in elderly or volume-depleted patients, and may contribute to hyperkalemia.
How serious is the interaction between Hydrochlorothiazide-losartan and Salsalate?
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 or changing salsalate. Maintain hydration and consider a non-NSAID analgesic such as paracetamol in high-risk patients.
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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