Drug interactions
Hydrochlorothiazide-telmisartan + Mefenamic acid
Severity: Major
Hydrochlorothiazide-telmisartan 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 can reduce the blood pressure lowering of telmisartan and hydrochlorothiazide and increases the risk of acute kidney injury and hyperkalemia. The risk is greatest in older, dehydrated or renally impaired patients.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan 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-telmisartan belongs to Cardiovascular; Mefenamic acid belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis causes sodium and water retention and lowers glomerular filtration in the presence of ARB and diuretic.
What to do
Avoid prolonged NSAID use with this combination, using paracetamol or the shortest NSAID course if needed. Monitor blood pressure, creatinine and potassium and ensure adequate 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 Mefenamic acid
- Ketorolac intranasal + Mefenamic acid Contraindicated
- Ketorolac + Mefenamic acid Contraindicated
- Aceclofenac + Mefenamic acid Major
- Acemetacin + Mefenamic acid Major
- Acetylsalicylic acid + Mefenamic acid Major
- Alteplase + Mefenamic acid Major
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Mefenamic acid?
MediHelp rates the interaction as major. Hydrochlorothiazide-telmisartan 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 can reduce the blood pressure lowering of telmisartan and hydrochlorothiazide and increases the risk of acute kidney injury and hyperkalemia. The risk is greatest in older, dehydrated or renally impaired patients.
How serious is the interaction between Hydrochlorothiazide-telmisartan 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 prolonged NSAID use with this combination, using paracetamol or the shortest NSAID course if needed. Monitor blood pressure, creatinine and potassium and ensure adequate 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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