Kidney Health Australia urges caution on “triple whammy” risks

Around one in 10 Australian adults who take certain medications for elevated blood pressure could be at risk of a potentially fatal interaction known as the “Triple Whammy” because they are using non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen at the same time, according to a new survey released by Kidney Health Australia.

The so called ‘Triple Whammy” occurs where people with high blood pressure, who are taking two different medications (for example ACE inhibitors together with diuretics) increase their risk of kidney failure by simultaneously taking a third drug, an NSAID. Another class of blood pressure medications known as ARBs behave just like ACE inhibitors in this regard.

The warning comes following the earlier release of the latest Bulletin to doctors, and pharmacists from the Adverse Drug Reactions Advisory Committee’ which urges healthcare professionals to “avoid the triple whammy where possible”. However, if these drugs are necessary, prescribers should be alert for situations such as illness, dehydration or initiation of an NSAID, which may predispose patients on this combination to kidney failure, and advise patients to seek medical advice during such episodes.

The National Prescribing Service also issued information to doctors earlier this year saying the “triple whammy should be avoided if possible and extreme caution should be taken with ACE inhibitors and NSAIDs in patients with renal [kidney] impairment.”

The Kidney Health Australia survey – of 601 Australians aged 50 years plus who were currently taking blood pressure medications – found that only 50% of people taking blood pressure medications recall being warned by their doctor or pharmacist about the risk of adding an anti-inflammatory medication, and 37% of people taking these medicines, sometimes or never read the accompanying warning labels.

Kidney Health Australia is urging consumers to take the following action to reduce the risk of kidney problems related to the “Triple Whammy”.

* Always read and follow the instructions on the pack of any medicines you are taking
* Do not use NSAID medications like ibuprofen if you are taking medicines for high blood pressure
* Talk to your pharmacist, GP or kidney specialist if you have any questions or concerns about your current medications.