Moderate
Established
Description
Ibuprofen reduces the diuretic and antihypertensive efficacy of spironolactone and may exacerbate renal insufficiency in high-risk patients.
Mécanisme
NSAIDs inhibit prostaglandin synthesis, causing sodium retention and reducing the natriuretic effect of spironolactone; together they impair renal tubular secretion and glomerular filtration.
Signification clinique
Clinically significant in patients with heart failure where diuretic response is critical; fluid overload and cardiac decompensation can result.
Prise en charge
Avoid NSAIDs in spironolactone-treated patients; monitor renal function and electrolytes closely if co-administration is unavoidable.