Drug interactions
Hydrochlorothiazide-valsartan + Sulindac
Severity: Moderate
Hydrochlorothiazide-valsartan 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 antihypertensive effect of valsartan and hydrochlorothiazide. The combination, especially with volume depletion, in older adults or with renal impairment, raises the risk of acute kidney injury and hyperkalemia.
What this interaction means in plain words
Hydrochlorothiazide-valsartan 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-valsartan belongs to Cardiovascular; Sulindac belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal perfusion and sodium excretion, opposing diuretic and ARB effects and impairing glomerular filtration.
What to do
Monitor blood pressure, serum creatinine and potassium after starting or changing the NSAID, and keep the patient hydrated. Use the lowest effective NSAID dose for the shortest time or choose an alternative analgesic.
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-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 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-valsartan with Sulindac?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-valsartan 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 antihypertensive effect of valsartan and hydrochlorothiazide. The combination, especially with volume depletion, in older adults or with renal impairment, raises the risk of acute kidney injury and hyperkalemia.
How serious is the interaction between Hydrochlorothiazide-valsartan 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: Monitor blood pressure, serum creatinine and potassium after starting or changing the NSAID, and keep the patient hydrated. Use the lowest effective NSAID dose for the shortest time or choose an alternative analgesic.
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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