Compatibility «Diclofenac» and «Hydrochlorothiazide+Losartan»

• Interactions Diclofenac with Hydrochlorothiazide+Losartan

  • Dangerous interactions
    • ⓘ The simultaneous use of ARA II or diuretics and NSAIDs may cause an increased risk of deterioration of renal function, in pm acute renal failure and increased potassium content in blood plasma, especially in patients with initial renal impairment.
    • ⓘ In some patients with impaired renal function treated with NSAIDs, in pm with selective COX-2 inhibitors, the simultaneous use of ARA II may worsen renal dysfunction.
    • ⓘ In some patients with impaired renal function treated with NSAIDs, in pm with selective COX-2 inhibitors, the simultaneous use of ARA II may exacerbate renal dysfunction.
    • ⓘ Increases the toxicity of methotrexate, cyclosporine, the likelihood of side effects of glucocorticoids (gastrointestinal bleeding), the risk of hyperkalemia on the background of potassium-sparing diuretics, reduces the effect of diuretics.
    • ⓘ In elderly patients with hypovolemia (in pm receiving diuretics) or renal insufficiency, the combined use of NSAIDs and ACE inhibitors or ARA II may lead to deterioration of renal function, including the possible development of acute renal failure.
    • ⓘ It should be used with caution with hypotensive drugs (their effect is potentiated, dose adjustment may be necessary), cardiac glycosides (hypokalemia and hypomagnesemia associated with the action of thiazide diuretics may increase the toxicity of digitalis), amiodarone (its use simultaneously with thiazide diuretics may lead to an increased risk of arrhythmias associated with hypokalemia), hypoglycemic oral medications (their effectiveness decreases, hyperglycemia may develop), corticosteroids, calcitonin (increase potassium excretion), NSAIDs (may weaken the diuretic and hypotensive effects of thiazides), non-depolarizing muscle relaxants (their effect may be enhanced), amantadine (clearance of amantadine may decrease with hydrochlorothiazide, which leads to an increase in plasma concentration of amantadine and possible toxicity), colestyramine (reduces absorption of hydrochlorothiazide), ethanol, barbiturates and narcotic analgesics, which enhance the effect of orthostatic hypotension.
    • ⓘ With the simultaneous use of diclofenac and ACE inhibitors or ARA II in elderly patients with hypovolemia or impaired renal function, signs of deterioration in renal function should be monitored.
    • ⓘ In elderly patients with a decrease in the volume of intercellular fluid (including those receiving diuretics) or with impaired renal function, the combined use of NSAIDs, including selective COX-2 inhibitors, with ARA II (including losartan) may lead to deterioration of renal function, including the possible development of acute renal failure.
  • Negative interactions
    • ⓘ With the simultaneous use of ARA II and NSAIDs (for example, selective COX-2 inhibitors, acetylsalicylic acid in doses > 3 g / day and non-selective NSAIDs), there may be a weakening of the antihypertensive effect of the combination hydrochlorothiazide + losartan.
    • ⓘ NSAIDs can reduce the diuretic and antihypertensive effects of hydrochlorothiazide.
    • ⓘ With the simultaneous use of ARA II and NSAIDs, for example, selective COX-2 inhibitors, acetylsalicylic acid in doses used for anti-inflammatory effect, and non-selective NSAIDs, there may be a weakening of the antihypertensive effect of losartan.
    • ⓘ Clinical studies, as well as post-registration observations, have shown that NSAIDs reduce the natriuretic effect of loop (for example, furosemide) and thiazide diuretics in some patients.
    • ⓘ With the simultaneous use of diclofenac with diuretics, the condition of patients should be monitored for signs of deterioration in renal function.
    • ⓘ It is necessary to periodically monitor kidney function in patients receiving losartan and NSAIDs.
    • ⓘ The antihypertensive effect of ARA II, including losartan, can be weakened by NSAIDs, including selective COX-2 inhibitors.
  • Positive interactions
    • ⓘ NSAIDs, including selective COX-2 inhibitors and high doses of acetylsalicylic acid (>3 g /day).
    • ⓘ Nonsteroidal anti-inflammatory drugs (NSAIDs), including selective cyclooxygenase-2 (COX-2) inhibitors and high doses of acetylsalicylic acid (≥3 g/day).
  • Unclear interactions
    • ⓘ Diuretics.
    • ⓘ NSAIDs, including selective COX-2 inhibitors.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

Video instruction

▶

Look at ▶Youtube

Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
• Why do I need to
  • Avoid dangerous prescriptions for your patients.
  • Check the contraindications.
  • Evaluate the safety of therapy in the treatment of children.
  • See the compatibility of drugs with alcohol (enter it as a drug).
  • Point the doctor to the found interaction - you may need to adjust the therapy.
  • Do you need an API for interactions/drug analogues for your project? Write to us.
• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 169,994,378 possible combinations of drugs and their components were found 412,530 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2024-12-19

Category - medicine