OTC Pain Relievers Safe With Lasix (Furosemide)?
In our latest question and answer, the pharmacist discusses pain reliever options if you are taking furosemide.
I take 40 mg of furosemide twice a day for edema and have developed horrible foot pain (in the arch of my foot). What can I take for the foot pain that will not interact with furosemide, as these two should not be taken at the same time?
Aug 02, 2025- Acetaminophen (Tylenol) is the preferred over-the-counter pain reliever to use with furosemide because NSAIDs like ibuprofen and naproxen can reduce the diuretic's effectiveness and increase the risk of kidney injury. NSAIDs combined with furosemide pose greater risks, especially if you're also taking other medications that affect kidney function like ACE inhibitors or ARBs. Talk to your doctor about which pain reliever is safest for your specific situation before starting any new medication.
Answer
Thanks for your question! It's a great one to discuss.
There are several over-the-counter pain relievers available, and I imagine you're looking for an oral option that's safe to take with furosemide to help with the pain in your foot. In this answer, I'll discuss whether combining furosemide with a pain reliever poses any risks in terms of drug interactions.
OTC Oral Pain Relievers and Furosemide
Common OTC pain relievers include:
- Tylenol (acetaminophen)
- Advil/Motrin (ibuprofen)
- Aleve (naproxen)
Advil and Motrin are NSAIDs, and they are the most concerning here.
Furosemide is a loop diuretic that works primarily by blocking sodium reabsorption in the kidneys. NSAIDs like ibuprofen and naproxen can interfere with this process by reducing blood flow to the kidneys and blocking prostaglandins that help maintain kidney function. This means they can reduce the diuretic effect of furosemide and potentially affect how well your body manages fluid balance.
In addition, combining an NSAID with a diuretic can increase the risk of acute kidney injury, particularly if you're also taking an ACE inhibitor or ARB (two drugs which are very commonly used alongside diuretics for blood pressure or heart-related conditions). The risk varies depending on factors like your kidney function, hydration status, and overall health.
Some NSAIDs may have less of an effect on furosemide, but caution is still needed. Overall, while there are situations where NSAIDs can be used with furosemide, it generally isn't the safest or first choice, especially for long-term use.
For most people taking furosemide, Tylenol (acetaminophen) is the preferred pain reliever. It doesn't interfere with kidney function or fluid balance like NSAIDs can. However, it does come with its own risks and because of this, I recommend you speak to your doctor regarding the safest choice for your specific situation.
Recommendation
It's not totally unheard of to take NSAIDs while on furosemide, but there are the concerns I wrote about above, like the fact that NSAIDs can reduce the effectiveness of furosemide and may increase the risk of kidney injury, especially if you're also taking other medications that affect the kidneys.
Just as important as interactions is the condition you're treating with furosemide. If it's being used for something like heart failure, NSAIDs could potentially worsen the condition by causing fluid retention or elevating blood pressure. For that reason, acetaminophen (Tylenol) is usually the safer go-to option for pain relief in this setting.
Having said all of this, a short course of an NSAID may sometimes be appropriate, especially if Tylenol doesn't provide enough relief, but this should be discussed with your doctor.
They can review your full medication list and medical history to determine the safest approach for managing your pain.
Final Words
Thanks again for reaching out, we're always here to help!
References & sources
- Non-steroidal anti-inflammatory drugs and frusemide-induced diuresis — PubMed
- Antagonistic effect of non-steroidal anti-inflammatory drugs on frusemide-induced diuresis in cardiac failure — PubMed
- Combined use of nonsteroidal anti-inflammatory drugs with diuretics and/or renin-angiotensin system inhibitors in the community increases the risk of acute kidney injury — PubMed
- Concurrent use of diuretics, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers with non-steroidal anti-inflammatory drugs and risk of acute kidney injury: nested case-control study — PubMed
Glossary — Terms in This Answer
- Loop diuretic
- A medication that increases urine production by blocking the kidneys' reabsorption of sodium, helping to remove excess fluid from the body.
- NSAIDs
- Non-steroidal anti-inflammatory drugs, a class of pain relievers that reduce inflammation and pain but can affect kidney function.
- Prostaglandins
- Natural substances in the body that help protect kidney function and maintain blood flow to the kidneys.
- Diuretic effect
- The ability of a medication to increase the amount of urine your body produces and remove excess fluid.
- Acute kidney injury
- A sudden loss of kidney function that can occur when certain medications are combined, potentially causing serious health problems.
- ACE inhibitor
- A type of blood pressure medication that can increase the risk of kidney problems when combined with diuretics and NSAIDs.
- ARB
- A blood pressure medication similar to ACE inhibitors that, when taken with diuretics and NSAIDs, can increase the risk of kidney damage.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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