, Volume 30, Issue 1, pp 32–41 | Cite as

Interactions of NSAIDs with Diuretics and β-Blockers

Mechanisms and Clinical Implications
  • J. Webster
Review Article


Indomethacin attenuates the antihypertensive effect of both thiazide diuretics and β-adrenoceptor blocking drugs. The mechanisms of these interactions are poorly understood but sodium and water retention, suppression of plasma renin activity, alterations in adrenoceptor sensitivity and impaired synthesis of vasodilator prostaglandins may all contribute to this effect. Other non-steroidal anti-inflammatory drugs (NSAIDs) may share this property of indomethacin but sulindac, which is a selective inhibitor of extrarenal prostaglandin synthesis, appears not to. This may have important clinical and theoretical implications. Clinicians must beware of this potential interaction in any patient receiving treatment for hypertension.

NSAIDs may also inhibit the natriuretic response to diuretics with resultant adverse effects in patients with heart failure and other forms of oedema. NSAIDs may also have adverse nephrotoxic effects which may be exacerbated by diuretic therapy.


Indomethacin Atenolol Thiazide Prostacyclin Plasma Renin Activity 
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Copyright information

© ADIS Press Limited 1985

Authors and Affiliations

  • J. Webster
    • 1
  1. 1.Department of Therapeutics and Clinical Pharmacology, Aberdeen Royal InfirmaryUniversity of AberdeenForesterhill, AberdeenScotland

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