Drug interactions
Hydrochlorothiazide-telmisartan + Piroxicam
Severity: Major
Hydrochlorothiazide-telmisartan and Piroxicam: 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
Piroxicam can blunt the antihypertensive effect of telmisartan and hydrochlorothiazide and increases the risk of acute kidney injury and hyperkalemia, especially in elderly or volume-depleted patients.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Piroxicam 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; Piroxicam belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandins promotes sodium retention and lowers glomerular filtration in combination with ARB and diuretic.
What to do
Avoid or minimize NSAID use and consider paracetamol. 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 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-telmisartan with Piroxicam?
MediHelp rates the interaction as major. Hydrochlorothiazide-telmisartan and Piroxicam 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. Piroxicam can blunt the antihypertensive effect of telmisartan and hydrochlorothiazide and increases the risk of acute kidney injury and hyperkalemia, especially in elderly or volume-depleted patients.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Piroxicam?
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 or minimize NSAID use and consider paracetamol. 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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