Moderate
Established
Descripción
NSAIDs blunt the diuretic and antihypertensive effects of furosemide and may precipitate acute kidney injury through reduced renal perfusion.
Mecanismo
Furosemide's diuretic effect depends partly on prostaglandin-mediated renal vasodilation; NSAIDs inhibit prostaglandin synthesis, reducing furosemide efficacy and further impairing renal perfusion.
Relevancia clínica
Diuretic resistance and edema worsening can occur; in heart failure patients, fluid retention may precipitate decompensation.
Manejo clínico
Avoid NSAIDs in patients on loop diuretics, particularly those with heart failure or CKD. Monitor weight, blood pressure, and renal function.