Acute renal failure indometacin

The GP then added in indometacin, which compromised renal perfusion. The combination therapy of an NSAID, an ACE inhibitor and a diuretic in an elderly patient who because of his age already has reduced renal function, induced a state of acute renal failure. 

Alcohol may increase the risk of gastrointestinal haemorrhage associated with NSAIDs. The skills related to driving are impaired by indometacin and phenylbutazone and this is made worse if patients drink alcohol while taking phenylbutazone, but this does not appear to occur with indometacin. A few isolated reports attribute acute renal failure to the concurrent use of NSAIDs and acute excessive alcohol consumption. 

The concurrent use of two or more NSAIDs increases the risk of gastrointestinai damage. Diflunisal raises serum indometacin levels about twofold but does not affect naproxen levels. The concurrent use of indometacin and flurbiprofen does not appear to affect the pharmacokinetics of either drug. Floctafenine does not alter diclofenac levels. Indometacin caused renal impairment in a patient recovering from phenylbutazone-induced acute renal failure. 

The concurrent use of triamterene and indometacin has, in several cases, rapidly lead to acute renal failure. An isolated case of renal impairment with diclofenac has been reported in a patient taking triamterene plus a thiazide. A case of exercise-induced acute renal failure has also been reported in a patient taking ibu-... 

A study in 4 healthy subjects found that indometacin 150 mg daily given with triamterene 200 mg daily over a 3-day period reduced the creatinine clearance in 2 subjects by 62% and 72%, respectively. Renal function returned to normal after a month. Indometacin alone caused an average 10% fall in creatinine clearance, but triamterene alone caused no consistent change in renal function. No adverse reactions were seen in 18 other subjects treated in the same way with indometacin and furosemide, hydrochlorothiazide or spironolactone. Five patients are reported to have rapidly developed acute renal failure after receiving indometacin and triamterene, either concurrently or sequentially. " ... 

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