PATIENTS who are prescribed a diuretic and a renin-angiotensin system (RSA) inhibitor, such as an angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), to control their hypertension (high blood pressure), should avoid taking ibuprofen, according to new research published in the journal Mathematical Biosciences.

Diuretics and RSA inhibitors are available by prescription under a variety of pharmaceutical brand names while painkillers such as ibuprofen are mostly available over-the-counter under different name brands such as Advil or Motrin.

Researchers at the University of Waterloo looked at the interactions of diuretics, RSA, and ibuprofen using computer-simulated drug trials. The investigators found that in some patients with certain medical profiles, the combination of the three medications could cause kidney damage, which in some cases can be permanent, according to a news release.

“Diuretics are a family of drugs that make the body hold less water,” Anita Layton, professor of applied mathematics at Waterloo and Canada 150 Research Chair in mathematical biology and medicine said in the release.

Layton further explained in the report, “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.”

The release explained that computer-simulated drug trials could provide researchers with results faster than in human clinical trials. Layton and her research team used mathematics and computer science to provide medical practitioners “a head start with issues like drug complications,” the release said.

Layton did note in the release, “It’s not that everyone who happens to take this combination of drugs is going to have problems,” and added, “But the research shows it’s enough of a problem that you should exercise caution.”

The study stated that the triple medication therapy, known as “triple whammy,” was associated with a 31% increased risk for acute kidney injury, compared to patients treated with diuretic and ACE inhibitor/ARB only. The published report also stated that triple whammy acute kidney injury (AKI) occurs in 0.88%-22% of triple treatment patients.

“Our simulation results reveal a key role of the myogenic response in determining the risk of AKI,” the study authors stated in the published report. Myogenic response is the mechanism by which the blood vessel diameter constricts after an increase in pressure and increases in diameter after a decrease in this pressure to maintain appropriate blood flow, experts explain.

“We hypothesize that individuals with an impaired myogenic response may be particularly susceptible to triple whammy AKI. Additionally, increased drug sensitivity or low water intake can predispose patients to triple whammy AKI,” the investigators wrote in their study. Health experts said it is important for anyone taking medication to check with their physician or pharmacist before taking an over the counter medication or supplement to avoid any drug interactions.

(SD-Agencies)