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Review
. 2022 Jan;39(1):140-147.
doi: 10.1007/s12325-021-01939-9. Epub 2021 Nov 29.

Drug Interactions Affecting Kidney Function: Beware of Health Threats from Triple Whammy

Tomasz Harężlak  1   2 , Urszula Religioni  3 , Filip M Szymański  4 , Dagmara Hering  5 , Agnieszka Barańska  6 , Agnieszka Neumann-Podczaska  7 , Matthew Allan  8 , Piotr Merks  9
Affiliations
Review

Drug Interactions Affecting Kidney Function: Beware of Health Threats from Triple Whammy

Tomasz Harężlak et al. Adv Ther. 2022 Jan.

Abstract

Triple whammy (TW) is a potentially dangerous drug combination that can lead to acute kidney injury (AKI). This drug interaction (DI) occurs when angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) are used together with diuretics and non-steroidal anti-inflammatory drugs (NSAIDs). One of the most serious consequences of TW DI is an increased risk of developing pre-renal acute kidney injury (pr-AKI). The term TW, in the context of a DI affecting kidney function, is not very widespread. The aim of this article was to gather information on this interaction. Previous knowledge on the mechanism of TW and how to increase patient awareness of this interaction is described. In addition, the specific nature of the acute kidney injury (AKI) caused by triple whammy (AKITW) is presented. On the basis of the current state of knowledge, recommendations on how to manage the TW DI are also demonstrated.

Keywords: ACEIs; Acute kidney injury; Drug interactions; NSAIDs; Triple whammy.

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