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