Aspirin may reduce the diuretic effect of
bumetanide,
furosemide, and piretanide, and the combination of
aspirin and
furosemide may increase the risk of acute
renal failure and salicylate
toxicity. The risk of ototoxicity with high doses of salicylates may theoretically be increased by loop
diuretics.
The
clinical significance of this interaction is unclear. However,
aspirin should be avoided in patients with recurrent hospital admissions for worsening heart failure. Be aware that
renal impairment and otoxicity are a possibility in patients receiving high dose of salicylates, and consider increasing monitoring for these effects.