Drug interactions between antihypertensive drugs and non-steroidal anti-inflammatory agents: a descriptive study using the French Pharmacovigilance database

• Published in: Fundamental & clinical pharmacology Vol. 28; no. 2; pp. 230 - 235
• Main Authors: Fournier, Jean-Pascal, Sommet, Agnès, Durrieu, Geneviève, Poutrain, Jean-Christophe, Lapeyre-Mestre, Maryse, Montastruc, Jean-Louis
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01.04.2014; Blackwell; Wiley
• Subjects: acute kidney injury; Adverse Drug Reaction Reporting Systems; Adverse Drug Reaction Reporting Systems Aged Aged, 80 and over Anti-Inflammatory Agents, Non-Steroidal / adverse effects Antihypertensive Agents / adverse effects Databases, Pharmaceutical Drug Interactions Drug-Related Side Effects and Adverse Reactions / epidemiology Drug-Related Side Effects and Adverse Reactions / etiology Female France / epidemiology Humans Male Middle Aged Pharmacovigilance; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; antihypertensive agents; Antihypertensive Agents - adverse effects; Biological and medical sciences; Databases, Pharmaceutical; Drug Interactions; Drug-Related Side Effects and Adverse Reactions - epidemiology; Drug-Related Side Effects and Adverse Reactions - etiology; Female; France - epidemiology; Human health and pathology; Humans; Kidneys; Life Sciences; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; non-steroidal anti-inflammatory drugs; Pharmacology. Drug treatments; Pharmacovigilance; Urinary system involvement in other diseases. Miscellaneous; France; Europe; Kidney disease; Non steroidal antiinflammatory agent; Drug; Urinary system disease; drug interactions; Acute kidney injury; Database; Antihypertensive agent; Drug interaction; antihypertensive agents; non-steroidal anti-inflammatory drugs; Pharmacovigilance; acute kidney injury; Drug interactions; Antihypertensive agents; Non-steroidal anti-inflammatory drugs
• ISSN: 0767-3981; 1472-8206; 1472-8206
• DOI: 10.1111/fcp.12014

Drug–drug interactions (DDIs) between antihypertensive drugs and non‐steroidal anti‐inflammatory drugs (NSAIDs) can lead to adverse drug reactions (ADRs). Guidelines are available to help prescribers deal with these drug associations, but their implementation is not well evaluated. The aims of this study were to assess the prevalence of NSAIDs exposure in patients treated with antihypertensive drugs, using the French Pharmacovigilance database, and explore the ADRs related to DDIs between antihypertensive drugs and NSAIDs. Over the 11, 442 notifications of ADRs recorded in this database in patients treated with oral antihypertensive drugs between 2008 and 2010, 517 (4.5 and 95% CI: 4.1–4.9) also included exposure to NSAIDs. These subjects were more frequently women, took more drugs in general, and were younger and less frequently treated with antiplatelet drugs. In 24.2% of them (125 patients), a DDI between NSAIDs and antihypertensive drugs was potentially the cause of the reported ADR. Acute renal failure caused by DDIs between NSAIDs and angiotensin‐converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), or diuretics was the most frequently reported ADR (20.7%). Finally, in the French Pharmacovigilance database, around one‐fourth of associations NSAIDs  +  antihypertensive drugs are associated with a ‘serious’ ADR (mainly acute renal failure), suggesting that this well‐known DDI is not enough taken into account by prescribers.