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