Drug interactions
Hydrochlorothiazide-telmisartan + Naproxen
Severity: Major
Hydrochlorothiazide-telmisartan and Naproxen: 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
Naproxen can weaken the blood pressure lowering of telmisartan and hydrochlorothiazide and raises the risk of acute kidney injury and hyperkalemia. This 'triple whammy' risk is highest in elderly or dehydrated patients.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Naproxen 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; Naproxen belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandins reduces glomerular perfusion and promotes sodium retention alongside ARB and diuretic effects.
What to do
Avoid regular NSAID use or use the lowest dose briefly. Monitor blood pressure, creatinine and potassium, and ensure 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 Naproxen
- Ketorolac intranasal + Naproxen Contraindicated
- Ketorolac + Naproxen Contraindicated
- Aceclofenac + Naproxen Major
- Acemetacin + Naproxen Major
- Acetylsalicylic acid + Naproxen Major
- Alteplase + Naproxen Major
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Naproxen?
MediHelp rates the interaction as major. Hydrochlorothiazide-telmisartan and Naproxen 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. Naproxen can weaken the blood pressure lowering of telmisartan and hydrochlorothiazide and raises the risk of acute kidney injury and hyperkalemia. This 'triple whammy' risk is highest in elderly or dehydrated patients.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Naproxen?
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 or use the lowest dose briefly. Monitor blood pressure, creatinine and potassium, and ensure 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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