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