Drug interactions
Hydrochlorothiazide-olmesartan + Ibuprofen
Severity: Major
Hydrochlorothiazide-olmesartan and Ibuprofen: major 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
Ibuprofen can reduce the antihypertensive effect of olmesartan and hydrochlorothiazide. The NSAID, ARB and diuretic combination increases the risk of acute kidney injury and hyperkalemia, especially in elderly or dehydrated patients.
What this interaction means in plain words
Hydrochlorothiazide-olmesartan and Ibuprofen can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Hydrochlorothiazide-olmesartan belongs to Cardiovascular; Ibuprofen belongs to Musculoskeletal.
Why it happens
NSAID inhibition of vasodilatory renal prostaglandins reduces renal perfusion and sodium excretion, compounding ARB effects.
What to do
Prefer paracetamol where suitable. If ibuprofen is needed, use the lowest dose briefly, ensure hydration, and monitor blood pressure, creatinine and potassium.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Hydrochlorothiazide-olmesartan
- Aliskiren + Hydrochlorothiazide-olmesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-olmesartan Contraindicated
- Hydrochlorothiazide-olmesartan + Sparsentan Contraindicated
- Acemetacin + Hydrochlorothiazide-olmesartan Major
- Amifostine + Hydrochlorothiazide-olmesartan Major
- Amiloride + Hydrochlorothiazide-olmesartan Major
Other interactions of Ibuprofen
- Ibuprofen + Ketorolac Contraindicated
- Ibuprofen + Ketorolac intranasal Contraindicated
- Acemetacin + Ibuprofen Major
- Alteplase + Ibuprofen Major
- Amiloride + Ibuprofen Major
- Apixaban + Ibuprofen Major
Frequently asked questions
Can I take Hydrochlorothiazide-olmesartan with Ibuprofen?
MediHelp rates the interaction as major. Hydrochlorothiazide-olmesartan and Ibuprofen can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ibuprofen can reduce the antihypertensive effect of olmesartan and hydrochlorothiazide. The NSAID, ARB and diuretic combination increases the risk of acute kidney injury and hyperkalemia, especially in elderly or dehydrated patients.
How serious is the interaction between Hydrochlorothiazide-olmesartan and Ibuprofen?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer paracetamol where suitable. If ibuprofen is needed, use the lowest dose briefly, ensure hydration, and monitor blood pressure, creatinine and potassium.
What other medicines interact with Hydrochlorothiazide-olmesartan?
MediHelp also lists interactions of Hydrochlorothiazide-olmesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-olmesartan page.
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