enalapril and Periarthritis

Rapid degradation of renal function may occur in patients given drug regimens combining a converting enzyme inhibitor, a diuretic and a nonsteroidal anti-inflammatory drug.. A patient given flecainide and an enalapril /hydrochlorothiazide combination in a well-tolerated long-term regimen suddenly developed acute renal failure when a nonsteroidal anti-inflammatory drug was introduced leading to an overdose of the anti-arrhythmic drug.. A poor understanding of the elimination routes for anti-arrhythmic drugs and the risks involved when combined with nonsteroidal anti-inflammatory drugs modifying glomerular hemodynamics can lead to dangerous prescriptions and life-threatening situations in patients on multiple drug regimens.

Topics: Acute Kidney Injury; Aged; Angiotensin-Converting Enzyme Inhibitors; Anti-Arrhythmia Agents; Anti-Inflammatory Agents, Non-Steroidal; Antihypertensive Agents; Atrial Fibrillation; Diuretics; Drug Interactions; Drug Therapy, Combination; Electrocardiography; Enalapril; Flecainide; Heart Block; Humans; Hydrochlorothiazide; Hypertension; Iatrogenic Disease; Indomethacin; Male; Periarthritis; Sodium Chloride Symporter Inhibitors