Drug interactions
Azilsartan-chlorthalidone + Tolmetin
Severity: Major
Azilsartan-chlorthalidone and Tolmetin: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Tolmetin can antagonize the blood pressure lowering effects of azilsartan and chlorthalidone through sodium and fluid retention. With an ARB and diuretic it increases the risk of acute kidney injury and hyperkalemia, especially in older or volume-depleted patients.
What this interaction means in plain words
Azilsartan-chlorthalidone and Tolmetin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Azilsartan-chlorthalidone belongs to Cardiovascular; Tolmetin belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal perfusion and sodium excretion, compounding ARB and diuretic effects on glomerular filtration.
What to do
Avoid if possible, or use the lowest dose for the shortest time. Monitor blood pressure, creatinine and potassium and keep the patient hydrated.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Azilsartan-chlorthalidone
Other interactions of Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin Major
Frequently asked questions
Can I take Azilsartan-chlorthalidone with Tolmetin?
MediHelp rates the interaction as major. Azilsartan-chlorthalidone and Tolmetin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Tolmetin can antagonize the blood pressure lowering effects of azilsartan and chlorthalidone through sodium and fluid retention. With an ARB and diuretic it increases the risk of acute kidney injury and hyperkalemia, especially in older or volume-depleted patients.
How serious is the interaction between Azilsartan-chlorthalidone and Tolmetin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible, or use the lowest dose for the shortest time. Monitor blood pressure, creatinine and potassium and keep the patient hydrated.
What other medicines interact with Azilsartan-chlorthalidone?
MediHelp also lists interactions of Azilsartan-chlorthalidone with, for example, Aliskiren, Sparsentan, Aceclofenac. The full list is on the Azilsartan-chlorthalidone page.
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