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Discussion

Chf & Nsaids

I just read that those who have CHF should avoid taking NSAID's, especially if on ACEI's. Does anyone know why?

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  • Admin

from epocrates (in my pda), re: nsaids and aceis:

"monitor bp, renal fxn;

combo may decr. antihypertensive efficacy, incr. risk of nephrotoxicity (antagonistic effects, additive effects)"

you might try google or another search engine, using "nsaid acei drug interactions contraindications."

good question.

Quickly, 'cause it's late...or early...

Nephrotoxicity.

ACEIs have effects on the kidneys, hence monitoring of renal function, contraindication for use in patients with elevated Cr levels and using ARBs in folks with impaired renal function. NSAIDs are the same. Combine the possible toxic effects of these drugs with a disease state that may not be providing adequate perfusion to the kidneys, you've got a recipe for renal failure. And that's the last thing those folks need! Don't forget to factor in the zealous use of diuretics (lasix et. al.) in CHFers - another stress on those kidneys. Besides, if the kidneys don't work, how are ya' going to get the fluid off?

My $0.02

Cheers,

Tom

feel free to correct me...I may be way off and like I said, it is early/late...

dont forget about the effects NSAIDs have on prostaglandins...

ps

this DOES NOT INCLUDE ASA. They should still take ASA....The AP benefits far outweigh the risks....

hi

what i can say about that is the NSAID will decrease the blood flow of the kidneys so renal impairment then fluid retention what we do not want with CHF

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