Moderate
Established
Description
Naproxen reduces the diuretic and antihypertensive efficacy of thiazide diuretics, blunting blood pressure control.
Mechanism
Thiazide diuretics rely on prostaglandin-mediated renal vasodilation for natriuresis; NSAID-mediated prostaglandin inhibition attenuates this mechanism, reducing diuretic response.
Clinical Significance
Systolic blood pressure may increase 3–6 mmHg; inadequate volume reduction may result in edema and hypertension.
Management
Prefer acetaminophen for analgesia; if NSAID is used, monitor blood pressure and consider increasing the antihypertensive dose temporarily.