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