Sodium retention indometacin

ANTI HYPERTENSIVES AND HEART FAILURE DRUGS NS AIDs 1 hypotensive effect, especially with indometacin. The effect is variable amongst different ACE inhibitors and NSAIDs, but is most notable between captopril and indometacin NSAIDs cause sodium and water retention and raise BP by inhibiting vasodilating renal prostaglandins. ACE inhibitors metabolize tissue kinins (e.g. bradykinin) and this may be the basis for indometacin attenuating hypotensive effect of captopril Monitor BP at least weekly until stable. Avoid co administering indometacin with captopril... 

BETA-BLOCKERS NSAIDS - INDOMETACIN, PIROXICAM, POSSIBLY IBUPROFEN, NAPROXEN 1 hypotensive efficacy of beta-blockers. There does not seem to be this effect with other NSAIDs Additive toxic effects on kidney, and sodium and water, retention by NSAIDs. NSAIDs can raise BP by inhibiting renal synthesis of vasodilating prostaglandins. It is uncertain why this effect is specific to these NSAIDs Watch for 1 response to beta-blockers... 

In a study in 111 patients with hypertension, losartan 50 mg once daily for 6 weeks reduced their blood pressure by a mean of 7.9/5.3 mmHg. Indometacin 75 mg once daily was then added for one week and this caused a rise in blood pressure in the group as a whole of 3.8/2.2 mmHg (reduction of about 45% in the effect of losartan). A rise in ambulatory diastolic blood pressure was seen in 69% of the losartan-treated patients during indometacin use. In contrast, a much smaller study in 10 patients with essential hypertension taking losartan found that indometacin 50 mg twice daily for one week caused sodium and fluid retention, but did not significantly attenuate the antihypertensive effects of losartan. ... 

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