Anyone who is taking a diuretic and a renin-angiotensin system (RSA) inhibitor to control their hypertension (high blood pressure) should be cautious about also taking ibuprofen, a new research published in the journal Mathematical Biosciences states.

The RSA inhibitor includes an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB). These along with diuretics are available by prescription under a variety of pharmaceutical brand names. However, painkillers such as ibuprofen can be available over-the-counter.

Researchers at the University of Waterloo analyzed the combination of the drugs using computer-simulated drug trials.

Also Read | 1 drug company settles ahead of San Francisco opioid trial

The investigators found that in some patients with certain medical profiles, the combination could cause kidney injury, sometimes leading to permanent damage of the organ.

“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 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 research also found that those taking drugs for hypertension may sometimes reach for a painkiller with ibuprofen without giving it much thought.

Also Read | Here are a few ways to keep your kidneys healthy and strong

“Diuretics are a family of drugs that make the body hold less water,” Layton said. “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.”

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

Also Read | Forbid me, but don’t do this to your kidney! 10 habits to stop

The ‘triple whammy,’ which is also known as triple medication therapy was linked to a 31% increased risk of acute kidney injury, compared to those patients who had only consumed diuretic and ACE inhibitor/ARB for treatment.

The study also sad that 0.88%–22% of triple treatment patients suffered acute kidney injury.

“Our simulation results reveal a key role of the myogenic response in determining the risk of AKI,” the study’s authors stated in the published report. .

“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.