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ibuprofen (bulk)

NSAIDs/Loop Diuretics

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, the nonsteroidal anti-inflammatory medicine may cause your diuretic (water pill) to not work as well.

What might happen:

You may experience a decrease in the beneficial effects of your diuretic (water pill).

What you should do about this interaction:

Contact your doctor if you experience headache; dizziness; blurred vision; trouble breathing; or swelling of ankles, feet, or hands. It may be necessary to adjust the dose of your medicine or change you to a different anti-inflammatory medicine.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Patak RV, Mookerjee BK, Bentzel CJ, Hysert PE, Babej M, Lee JB. Antagonism of the effects of furosemide by indomethacin in normal and hypertensive man. Prostaglandins 1975 Oct;10(4):649-59.
2.Donker AJ, Arisz L, Brentjens JR, van der Hem GK, Hollemans HJ. The effect of indomethacin on kidney function and plasma renin activity in man. Nephron 1976;17(4):288-96.
3.Brater DC. Analysis of the effect of indomethacin on the response to furosemide in man: effect of dose of furosemide. J Pharmacol Exp Ther 1979 Sep;210(3):386-90.
4.Smith DE, Brater DC, Lin ET, Benet LZ. Attenuation of furosemide's diuretic effect by indomethacin: pharmacokinetic evaluation. J Pharmacokinet Biopharm 1979 Jun;7(3):265-74.
5.Brater DC. Effect of indomethacin on salt and water homeostasis. Clin Pharmacol Ther 1979 Mar;25(3):322-30.
6.Brater C, Chennavasin P. Indomethacin and the response to bumetanide. Clin Pharmacol Ther 1980 Mar;27(3):421-5.
7.Pedrinelli R, Magagna A, Arzilli F, Sassano P, Salvetti A. Influence of indomethacin on the natriuretic and renin-stimulating effect of bumetanide in essential hypertension. Clin Pharmacol Ther 1980 Dec;28(6):722-31.
8.Allan SG, Knox J, Kerr F. Interaction between diuretics and indomethacin. Br Med J (Clin Res Ed) 1981 Dec 12;283(6306):1611.
9.Kaufman J, Hamburger R, Matheson J, Flamenbaum W. Bumetanide-induced diuresis and natriuresis: effect of prostaglandin synthetase inhibition. J Clin Pharmacol 1981 Nov-Dec;21(11-12 Pt 2):663-7.
10.Brater DC, Fox WR, Chennavasin P. Interaction studies with bumetanide and furosemide. Effects of probenecid and of indomethacin on response to bumetanide in man. J Clin Pharmacol 1981 Nov-Dec;21(11-12 Pt 2):647-53.
11.Bunning RD, Barth WF. Sulindac. A potentially renal-sparing nonsteroidal anti-inflammatory drug. JAMA 1982 Dec 3;248(21):2864-7.
12.Rawles JM. Antagonism between non-steroidal anti-inflammatory drugs and diuretics. Scott Med J 1982 Jan;27(1):37-40.
13.Poe TE, Scott RB, Keith JF Jr. Interaction of indomethacin with furosemide. J Fam Pract 1983 Mar;16(3):610, 614-6.
14.Wong DG, Spence JD, McDonald JWD, Lamki LM. Non-steroidal antiinflammatory drugs (NSAID) vs placebo in hypertension treated with diuretic and beta-blocker. Clin Pharmacol Ther 1984 Feb;35(2):284.
15.Radack KL, Deck CC, Bloomfield SS. Ibuprofen interferes with the efficacy of antihypertensive drugs. A randomized, double-blind, placebo-controlled trial of ibuprofen compared with acetaminophen. Ann Intern Med 1987 Nov; 107(5):628-35.
16.Skinner MH, Mutterperl R, Zeitz HJ. Sulindac inhibits bumetanide-induced sodium and water excretion. Clin Pharmacol Ther 1987 Nov;42(5):542-6.
17.Herchuelz A, Derenne F, Deger F, Juvent M, Van Ganse E, Staroukine M, Verniory A, Boeynaems JM, Douchamps J. Interaction between nonsteroidal anti-inflammatory drugs and loop diuretics: modulation by sodium balance. J Pharmacol Exp Ther 1989 Mar;248(3):1175-81.
18.Passmore AP, Copeland S, Johnston GD. The effects of ibuprofen and indomethacin on renal function in the presence and absence of frusemide in healthy volunteers on a restricted sodium diet. Br J Clin Pharmacol 1990 Mar;29(3):311-9.

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