Moderate
Established
Mô tả
Ibuprofen attenuates the antihypertensive effect of ARBs and increases the risk of renal impairment and hyperkalemia.
Cơ chế
Prostaglandin inhibition reduces renal afferent vasodilation, opposing the ARB-induced efferent dilation and overall renal blood flow benefits; combined RAAS blockade plus NSAID creates 'triple whammy' nephrotoxicity risk.
Ý nghĩa lâm sàng
Acute kidney injury incidence approximately doubles with combined ARB + NSAID; hyperkalemia risk is significant, especially with diuretic use.
Xử trí
Monitor renal function and electrolytes; avoid in patients with CKD, HF, or dehydration. Prefer non-NSAID analgesics.