Moderate
Established
الوصف
Ibuprofen attenuates the antihypertensive effect of ARBs and increases the risk of renal impairment and hyperkalemia.
الآلية
Prostaglandin inhibition reduces renal afferent vasodilation, opposing the ARB-induced efferent dilation and overall renal blood flow benefits; combined RAAS blockade plus NSAID creates 'triple whammy' nephrotoxicity risk.
الأهمية السريرية
Acute kidney injury incidence approximately doubles with combined ARB + NSAID; hyperkalemia risk is significant, especially with diuretic use.
التدبير
Monitor renal function and electrolytes; avoid in patients with CKD, HF, or dehydration. Prefer non-NSAID analgesics.