Drug interactions
Hydrochlorothiazide-telmisartan + Salsalate
Severity: Moderate
Hydrochlorothiazide-telmisartan and Salsalate: 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
Salsalate is an NSAID-like salicylate prodrug that can reduce the blood pressure lowering effect of telmisartan and hydrochlorothiazide. With an ARB and a diuretic, NSAID exposure raises the risk of acute kidney injury, particularly in older or volume-depleted patients, and may raise potassium.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Salsalate 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.
Why it happens
Inhibition of vasodilatory renal prostaglandins reduces glomerular perfusion and sodium excretion, opposing the ARB and diuretic and adding to renal hemodynamic stress.
What to do
Use the lowest effective salsalate dose for the shortest time, maintain hydration, and monitor blood pressure, creatinine and potassium. Consider a non-NSAID analgesic in high-risk patients.
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-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
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Salsalate?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-telmisartan and Salsalate 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. Salsalate is an NSAID-like salicylate prodrug that can reduce the blood pressure lowering effect of telmisartan and hydrochlorothiazide. With an ARB and a diuretic, NSAID exposure raises the risk of acute kidney injury, particularly in older or volume-depleted patients, and may raise potassium.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Salsalate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective salsalate dose for the shortest time, maintain hydration, and monitor blood pressure, creatinine and potassium. Consider a non-NSAID analgesic in high-risk patients.
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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