Drug interactions
Candesartan-hydrochlorothiazide + Ketorolac
Severity: Major
Candesartan-hydrochlorothiazide and Ketorolac: major 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
Ketorolac can reduce the blood pressure lowering effect of candesartan and hydrochlorothiazide. Together with an ARB and diuretic it can precipitate acute kidney injury and hyperkalemia, particularly in older or volume-depleted patients.
What this interaction means in plain words
Candesartan-hydrochlorothiazide and Ketorolac 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.
Candesartan-hydrochlorothiazide belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
Prostaglandin synthesis inhibition reduces renal perfusion and promotes sodium retention while the ARB removes efferent arteriolar compensation and the diuretic depletes volume.
What to do
Avoid or limit ketorolac to a short course with adequate hydration, and choose a safer analgesic where possible. Monitor creatinine, potassium, and blood pressure.
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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Other interactions of Candesartan-hydrochlorothiazide
- Aliskiren + Candesartan-hydrochlorothiazide Contraindicated
- Candesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Candesartan-hydrochlorothiazide + Sparsentan Contraindicated
- Acemetacin + Candesartan-hydrochlorothiazide Major
- Amifostine + Candesartan-hydrochlorothiazide Major
- Amiloride + Candesartan-hydrochlorothiazide Major
Other interactions of Ketorolac
- Aceclofenac + Ketorolac Contraindicated
- Acemetacin + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac Contraindicated
- Apixaban + Ketorolac Contraindicated
- Argatroban + Ketorolac Contraindicated
- Aspirin / citric acid / sodium bicarbonate + Ketorolac Contraindicated
Frequently asked questions
Can I take Candesartan-hydrochlorothiazide with Ketorolac?
MediHelp rates the interaction as major. Candesartan-hydrochlorothiazide and Ketorolac 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. Ketorolac can reduce the blood pressure lowering effect of candesartan and hydrochlorothiazide. Together with an ARB and diuretic it can precipitate acute kidney injury and hyperkalemia, particularly in older or volume-depleted patients.
How serious is the interaction between Candesartan-hydrochlorothiazide and Ketorolac?
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 or limit ketorolac to a short course with adequate hydration, and choose a safer analgesic where possible. Monitor creatinine, potassium, and blood pressure.
What other medicines interact with Candesartan-hydrochlorothiazide?
MediHelp also lists interactions of Candesartan-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Candesartan-hydrochlorothiazide page.
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