Indometacin may attenuate the antihypertensive effect of losartan,
valsartan, or other angiotensin II
receptor antagonists. No clinically relevant pharmacokinetic inter- actions occur between
telmisartan and
ibuprofen or between
valsartan and indometacin. The combination of an
NSAID and angiotensin II
receptor antagonist can increase the risk of
renal impairment and hyperkalaemia.
Several manufacturers of angiotensin II
receptor antagonists caution that, as with other
antihypertensives, the effects on blood pressure may be
attenuated by
NSAIDs such as indometacin. Patients taking losartan,
valsartan or other angiotensin II
receptor antagonists, who require indometacin, should be moni- tored for alterations in blood pressure
control. Other
NSAIDs seem likely to interact similarly. Poor
renal perfusion may increase the risk of
renal failure if angiotensin II
receptor antagonists are given with
NSAIDs and so regular hydration of the patient and monitoring of
renal function is recommended.