Drug interactions
Candesartan + Tolfenamic acid
Severity: Moderate
Candesartan and Tolfenamic acid: moderate interaction.
Last updated
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
Tolfenamic acid, an NSAID, can reduce the antihypertensive effect of candesartan. Together they raise the risk of acute kidney injury and hyperkalemia, especially in volume-depleted, elderly or renally impaired patients.
What this interaction means in plain words
Candesartan and Tolfenamic acid can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Candesartan belongs to Cardiovascular; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal perfusion and potassium excretion while the ARB removes angiotensin II-mediated efferent tone.
What to do
Use the shortest NSAID course at the lowest dose and ensure hydration. Check creatinine, potassium and blood pressure soon after starting.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Candesartan
- Aliskiren + Candesartan Contraindicated
- Candesartan + Sparsentan Contraindicated
- Amifostine + Candesartan Major
- Amiloride + Candesartan Major
- Amlodipine-benazepril + Candesartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Candesartan Major
Other interactions of Tolfenamic acid
Frequently asked questions
Can I take Candesartan with Tolfenamic acid?
MediHelp rates the interaction as moderate. Candesartan and Tolfenamic acid can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Tolfenamic acid, an NSAID, can reduce the antihypertensive effect of candesartan. Together they raise the risk of acute kidney injury and hyperkalemia, especially in volume-depleted, elderly or renally impaired patients.
How serious is the interaction between Candesartan and Tolfenamic acid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the shortest NSAID course at the lowest dose and ensure hydration. Check creatinine, potassium and blood pressure soon after starting.
What other medicines interact with Candesartan?
MediHelp also lists interactions of Candesartan with, for example, Aliskiren, Sparsentan, Amifostine. The full list is on the Candesartan page.
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