Drug interactions
Candesartan-hydrochlorothiazide + Tolmetin
Severity: Major
Candesartan-hydrochlorothiazide and Tolmetin: 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
Tolmetin, an NSAID, can blunt the blood pressure lowering effect of candesartan and hydrochlorothiazide. In combination with an ARB and a diuretic, it increases the risk of acute kidney injury and hyperkalemia, particularly in older or volume-depleted patients.
What this interaction means in plain words
Candesartan-hydrochlorothiazide 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.
Candesartan-hydrochlorothiazide belongs to Cardiovascular; Tolmetin belongs to Musculoskeletal.
Why it happens
Prostaglandin inhibition reduces renal perfusion and sodium excretion, opposing antihypertensive action and impairing renal function with RAAS blockade.
What to do
Avoid combination where possible, or use lowest NSAID dose for the shortest time with adequate 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 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 Candesartan-hydrochlorothiazide with Tolmetin?
MediHelp rates the interaction as major. Candesartan-hydrochlorothiazide 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, an NSAID, can blunt the blood pressure lowering effect of candesartan and hydrochlorothiazide. In combination with an ARB and a diuretic, it increases the risk of acute kidney injury and hyperkalemia, particularly in older or volume-depleted patients.
How serious is the interaction between Candesartan-hydrochlorothiazide 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 combination where possible, or use lowest NSAID dose for the shortest time with adequate 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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