Drug interactions
Hydrochlorothiazide-telmisartan + Ibuprofen
Severity: Major
Hydrochlorothiazide-telmisartan 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 blood pressure lowering effect of telmisartan and hydrochlorothiazide. The combination also raises the risk of acute kidney injury and hyperkalemia, particularly in older, dehydrated or renally impaired patients.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan 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-telmisartan belongs to Cardiovascular; Ibuprofen belongs to Musculoskeletal.
Why it happens
NSAID inhibition of prostaglandin synthesis lowers renal blood flow and causes sodium retention, while ARB blockade removes efferent compensation.
What to do
Prefer paracetamol or the lowest NSAID dose for the shortest period. Monitor blood pressure, creatinine and potassium and maintain hydration.
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-telmisartan
- Aliskiren + Hydrochlorothiazide-telmisartan Contraindicated
- Dofetilide + Hydrochlorothiazide-telmisartan Contraindicated
- Hydrochlorothiazide-telmisartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-telmisartan Major
- Amifostine + Hydrochlorothiazide-telmisartan Major
- Amiloride + Hydrochlorothiazide-telmisartan 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-telmisartan with Ibuprofen?
MediHelp rates the interaction as major. Hydrochlorothiazide-telmisartan 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 blood pressure lowering effect of telmisartan and hydrochlorothiazide. The combination also raises the risk of acute kidney injury and hyperkalemia, particularly in older, dehydrated or renally impaired patients.
How serious is the interaction between Hydrochlorothiazide-telmisartan 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 or the lowest NSAID dose for the shortest period. Monitor blood pressure, creatinine and potassium and maintain hydration.
What other medicines interact with Hydrochlorothiazide-telmisartan?
MediHelp also lists interactions of Hydrochlorothiazide-telmisartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-telmisartan page.
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