The antihypertensive and diuretic effects of loop
diuretics appear to be reduced by NSAIDs, although the extent of this interaction largely depends on the individual
NSAID. Indometacin appears to cause the most significant effect. Note that
diuretics increase the risk of NSAID-induced acute
renal failure.
Concurrent use need not be avoided but the effects should be checked and the diuretic dosage raised as necessary. Not all patients are affected. Patients at greatest risk are likely to be the elderly with cirrhosis, cardiac failure and/or
renal impairment, and they may need to avoid
NSAIDs.