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Drug interactions

Hydrochlorothiazide-olmesartan + Mefenamic acid

Severity: Major

Hydrochlorothiazide-olmesartan and Mefenamic acid: 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

Mefenamic acid with an ARB and thiazide increases the risk of acute kidney injury, particularly in elderly or volume-depleted patients. It also weakens blood pressure control and may promote hyperkalemia.

What this interaction means in plain words

Hydrochlorothiazide-olmesartan and Mefenamic acid 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; Mefenamic acid belongs to Musculoskeletal.

Evidence level: High

Why it happens

NSAID inhibition of renal prostaglandins reduces afferent arteriolar dilation, while ARB blocks efferent constriction and the diuretic reduces volume, impairing glomerular filtration.

What to do

Avoid regular NSAID use where possible; if needed 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Hydrochlorothiazide-olmesartan with Mefenamic acid?

MediHelp rates the interaction as major. Hydrochlorothiazide-olmesartan and Mefenamic acid 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. Mefenamic acid with an ARB and thiazide increases the risk of acute kidney injury, particularly in elderly or volume-depleted patients. It also weakens blood pressure control and may promote hyperkalemia.

How serious is the interaction between Hydrochlorothiazide-olmesartan and Mefenamic acid?

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 regular NSAID use where possible; if needed 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.

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