Ethacrynic acid and Irbesartan and hydrochlorothiazide interaction

Ethacrynic acid and Irbesartan and hydrochlorothiazide: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Ethacrynic acid label · effective 2023-08-31

Major

CONTRAINDICATIONS All diuretics, including ethacrynic acid, are contraindicated in anuria.

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Major

If increasing electrolyte imbalance, azotemia, and/or oliguria occur during treatment of severe, progressive renal disease, the diuretic should be discontinued.

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Major

In a few patients this diuretic has produced severe, watery diarrhea.

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Major

Like other diuretics it may precipitate hepatic coma and death.

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Major

A number of possibly drug-related deaths have occurred in critically ill patients refractory to other diuretics.

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From the Irbesartan and hydrochlorothiazide (Avalide) label · effective 2025-10-07

Moderate

Initiation of antihypertensive therapy may cause symptomatic hypotension in patients with intravascular volume or sodium depletion, e.g., in patients treated vigorously with diuretics or in patients on dialysis.

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Moderate

Coadministration of AVALIDE with potassium-sparing diuretics, potassium supplements, potassium-containing salt substitutes or other drugs that raise serum potassium levels may result in hyperkalemia, sometimes severe.

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Moderate

NSAIDs and selective COX-2 inhibitors: Can reduce diuretic, natriuretic of diuretic, may lead to increased risk of renal impairment and reduced antihypertensive effect.

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Moderate

Nonsteroidal Anti-inflammatory Agents Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors) Irbesartan In patients who are elderly, volume depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including irbesartan,…

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Moderate

Hydrochlorothiazide Administration of a nonsteroidal anti-inflammatory agent, including a selective COX-2 inhibitor can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing, and thiazide diuretics.

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.