Olmesartan and hydrochlorothiazide and Piroxicam interaction
Olmesartan and hydrochlorothiazide and Piroxicam: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.
Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.
What the FDA labels say
From the Olmesartan and hydrochlorothiazide (OLMESARTAN MEDOXOMIL and HYDROCHLOROTHIAZIDE) label · effective 2026-04-10
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic and antihypertensive effects; increased risk of renal toxicity ( 7.3 )
Non-Steroidal Anti-Inflammatory Agents Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors) Olmesartan medoxomil In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists (including…
Monitor renal function periodically in patients receiving olmesartan medoxomil and NSAID therapy.
Hydrochlorothiazide In some patients the administration of an NSAID can reduce the diuretic, natriuretic, and antihypertensive effects of thiazide diuretics.
The antihypertensive effect of angiotensin II receptor antagonists, including olmesartan medoxomil, may be attenuated by NSAIDs including selective COX-2 inhibitors.
From the Piroxicam label · effective 2026-07-08
Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors or ARBs, and the elderly.
ACE Inhibitors and ARBs: Concomitant use with Piroxicam Capsules in elderly, volume depleted, or those with renal impairment may result in deterioration of renal function.
Diuretics: NSAIDs can reduce natriuretic effect of furosemide and thiazide diuretics.
Monitor patients to assure diuretic efficacy including antihypertensive effects (7)
• In patients who are elderly, volume-depleted (including those on diuretic therapy), or have renal impairment, co-administration of an NSAID with ACE inhibitors or ARBs may result in deterioration of renal function, including possible acute renal failure.
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot 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.