Major
Ibuprofen × telmisartan
Non-steroidal anti-inflammatory drugs (NSAIDs)×Angiotensin II receptor blocker (ARB)
Mechanism
Similar to losartan + ibuprofen. NSAIDs reduce renal blood flow; the ARB (telmisartan) lowers glomerular pressure. The combination causes acute kidney injury.
Symptoms
Reduced urine output, rising creatinine and potassium, oedema. Symptoms appear earlier in older patients and in chronic kidney disease.
Management
Avoid prolonged combination. If ibuprofen is needed for a short course, use the minimum effective dose for 5–7 days with pantoprazole cover and creatinine monitoring. For chronic analgesia: paracetamol or celecoxib.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.