Drug interactions
Hydrochlorothiazide-olmesartan + Piroxicam
Severity: Moderate
Hydrochlorothiazide-olmesartan 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 reduce the blood pressure lowering effect of olmesartan and hydrochlorothiazide. The triple combination of an NSAID, ARB and diuretic raises the risk of acute kidney injury and hyperkalemia, particularly in elderly or dehydrated patients.
What this interaction means in plain words
Hydrochlorothiazide-olmesartan 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-olmesartan belongs to Cardiovascular; Piroxicam belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal perfusion and sodium excretion, opposing antihypertensive effects and adding to renal hemodynamic risk.
What to do
Prefer the lowest effective NSAID dose for the shortest duration or an alternative analgesic such as paracetamol. Monitor blood pressure, serum creatinine and potassium.
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-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 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-olmesartan with Piroxicam?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-olmesartan 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 reduce the blood pressure lowering effect of olmesartan and hydrochlorothiazide. The triple combination of an NSAID, ARB and diuretic raises the risk of acute kidney injury and hyperkalemia, particularly in elderly or dehydrated patients.
How serious is the interaction between Hydrochlorothiazide-olmesartan 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: Prefer the lowest effective NSAID dose for the shortest duration or an alternative analgesic such as paracetamol. Monitor blood pressure, serum 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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