Drug interactions
Candesartan-hydrochlorothiazide + Tolfenamic acid
Severity: Major
Candesartan-hydrochlorothiazide and Tolfenamic acid: 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
NSAIDs such as tolfenamic acid can reduce the antihypertensive effect of ARBs and thiazides. With an ARB plus diuretic, NSAIDs raise the risk of acute kidney injury and hyperkalemia, especially in dehydrated or elderly patients.
What this interaction means in plain words
Candesartan-hydrochlorothiazide and Tolfenamic acid 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; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal blood flow and sodium excretion, impairing renal function under RAAS blockade.
What to do
Avoid combination where possible or limit NSAID dose and duration with good hydration. Monitor blood pressure, creatinine and potassium.
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 Tolfenamic acid
Frequently asked questions
Can I take Candesartan-hydrochlorothiazide with Tolfenamic acid?
MediHelp rates the interaction as major. Candesartan-hydrochlorothiazide and Tolfenamic acid 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. NSAIDs such as tolfenamic acid can reduce the antihypertensive effect of ARBs and thiazides. With an ARB plus diuretic, NSAIDs raise the risk of acute kidney injury and hyperkalemia, especially in dehydrated or elderly patients.
How serious is the interaction between Candesartan-hydrochlorothiazide and Tolfenamic acid?
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 combination where possible or limit NSAID dose and duration with good hydration. Monitor blood pressure, creatinine and potassium.
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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