Drug interactions
Hydrochlorothiazide-valsartan + Indomethacin
Severity: Major
Hydrochlorothiazide-valsartan and Indomethacin: 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
Indomethacin can reduce the blood pressure lowering effect of valsartan and hydrochlorothiazide. Together with these drugs it increases the risk of acute kidney injury and hyperkalemia, particularly in older or volume-depleted patients.
What this interaction means in plain words
Hydrochlorothiazide-valsartan and Indomethacin 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-valsartan belongs to Cardiovascular; Indomethacin belongs to Musculoskeletal.
Why it happens
Inhibition of prostaglandin synthesis reduces renal blood flow and sodium excretion, which combined with angiotensin receptor blockade and diuretic volume loss impairs glomerular filtration.
What to do
Avoid combination where possible and choose an alternative analgesic such as paracetamol. If used, give the lowest dose for the shortest time and monitor blood pressure, creatinine and potassium.
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-valsartan
- Aliskiren + Hydrochlorothiazide-valsartan Contraindicated
- Dofetilide + Hydrochlorothiazide-valsartan Contraindicated
- Hydrochlorothiazide-valsartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-valsartan Major
- Amifostine + Hydrochlorothiazide-valsartan Major
- Amiloride + Hydrochlorothiazide-valsartan Major
Other interactions of Indomethacin
- Indomethacin + Ketorolac Contraindicated
- Indomethacin + Ketorolac intranasal Contraindicated
- Aceclofenac + Indomethacin Major
- Acemetacin + Indomethacin Major
- Acetylsalicylic acid + Indomethacin Major
- Alteplase + Indomethacin Major
Frequently asked questions
Can I take Hydrochlorothiazide-valsartan with Indomethacin?
MediHelp rates the interaction as major. Hydrochlorothiazide-valsartan and Indomethacin 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. Indomethacin can reduce the blood pressure lowering effect of valsartan and hydrochlorothiazide. Together with these drugs it increases the risk of acute kidney injury and hyperkalemia, particularly in older or volume-depleted patients.
How serious is the interaction between Hydrochlorothiazide-valsartan and Indomethacin?
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 combination where possible and choose an alternative analgesic such as paracetamol. If used, give the lowest dose for the shortest time and monitor blood pressure, creatinine and potassium.
What other medicines interact with Hydrochlorothiazide-valsartan?
MediHelp also lists interactions of Hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-valsartan page.
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