Combining certain BP medications with NSAIDs linked to kidney damage—acetaminophen seen as a safer option
Patients who take diuretics, renin-angiotensin system (RAD) inhibitors and non-steroidal anti-inflammatory drugs (NSAIDs) at the same time face a much higher risk of developing acute kidney injury (AKI), according to new research published in Mathematical Biosciences.[1]
“Mortality among AKI patients can be as high as 50% to 80% of cases in specific populations, such as critically ill patients,” wrote first author Jessica Leete, PhD, a computational biology and bioinformatics specialist at Duke University, and colleagues. “Understanding how each of these drugs affect renal autoregulation individually and in combination can help medical providers avoid prescribing dangerous combinations in at risk individuals and administer them with confidence to low-risk patients, especially to those who may benefit from pain killers for acute or chronic pain relief.”
Leete et al. noted that researchers have been studying the combination of diuretics, RAD inhibitors and NSAIDs — commonly known as the “triple whammy” — for quite some time now, pointing to one analysis published in BMJ in 2013.[2] Hoping to learn more, the group ran computer-simulated drug trials developed using mathematics and computer science to see how different patients may react to the triple whammy treatment.
Overall, the team’s model simulations found that both male and female patients are more likely to develop “triple whammy AKI” if they take all three therapies. Dehydration and a high sensitivity to drug treatment stood out as two key factors associated with such an injury.
“Diuretics are a family of drugs that make the body hold less water,” co-author Anita Layton, PhD, a professor of applied mathematics at the University of Waterloo, said in a statement. “Being dehydrated is a major factor in acute kidney injury, and then the RAS inhibitor and ibuprofen hit the kidney with this triple whammy. If you happen to be on these hypertension drugs and need a painkiller, consider acetaminophen instead.”
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