Drug interactions
Hydrochlorothiazide-telmisartan + Sulindac
Severity: Moderate
Hydrochlorothiazide-telmisartan and Sulindac: 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
NSAIDs such as sulindac can blunt the blood-pressure-lowering effect of telmisartan and hydrochlorothiazide. In volume-depleted or elderly patients, the combination of an NSAID, an angiotensin receptor blocker and a diuretic raises the risk of acute kidney injury and hyperkalemia.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Sulindac 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.
Hydrochlorothiazide-telmisartan belongs to Cardiovascular; Sulindac belongs to Musculoskeletal.
Why it happens
NSAIDs inhibit renal vasodilatory prostaglandins, reducing renal perfusion and sodium excretion while opposing antihypertensive effects, and impair efferent-arteriole compensation during angiotensin receptor blockade.
What to do
Prefer a non-NSAID analgesic where possible; if used, keep the dose and duration minimal and ensure hydration. Monitor blood pressure, serum creatinine and potassium.
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
Other interactions of Sulindac
- Ketorolac intranasal + Sulindac Contraindicated
- Ketorolac + Sulindac Contraindicated
- Aceclofenac + Sulindac Major
- Acetylsalicylic acid + Sulindac Major
- Alteplase + Sulindac Major
- Amiloride + Sulindac Major
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Sulindac?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-telmisartan and Sulindac 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. NSAIDs such as sulindac can blunt the blood-pressure-lowering effect of telmisartan and hydrochlorothiazide. In volume-depleted or elderly patients, the combination of an NSAID, an angiotensin receptor blocker and a diuretic raises the risk of acute kidney injury and hyperkalemia.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Sulindac?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-NSAID analgesic where possible; if used, keep the dose and duration minimal and ensure hydration. Monitor blood pressure, serum creatinine and potassium.
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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