Drug interactions
Hydrochlorothiazide-olmesartan + Indomethacin
Severity: Major
Hydrochlorothiazide-olmesartan and Indomethacin: 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
Indomethacin can markedly 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 older or volume-depleted patients.
What this interaction means in plain words
Hydrochlorothiazide-olmesartan and Indomethacin 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; Indomethacin belongs to Musculoskeletal.
Why it happens
NSAID inhibition of vasodilatory renal prostaglandins reduces renal perfusion and sodium excretion, compounding ARB effects on glomerular filtration.
What to do
Avoid combined use when possible, or use the lowest dose for the shortest time with adequate hydration. 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Hydrochlorothiazide-olmesartan and Indomethacin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Indomethacin
- Indomethacin + Ketorolac Contraindicated
- Indomethacin + Ketorolac intranasal Contraindicated
- Aceclofenac + Indomethacin Major
- Acemetacin + Indomethacin Major
- Acetylsalicylic acid + Indomethacin Major
- Alteplase + Indomethacin Major
Frequently asked questions
Can I take Hydrochlorothiazide-olmesartan with Indomethacin?
MediHelp rates the interaction as major. Hydrochlorothiazide-olmesartan and Indomethacin 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. Indomethacin can markedly 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 older or volume-depleted patients.
How serious is the interaction between Hydrochlorothiazide-olmesartan and Indomethacin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combined use when possible, or use the lowest dose for the shortest time with adequate hydration. 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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
