Drug interactions
Captopril-hydrochlorothiazide + Ketorolac
Severity: Major
Captopril-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 is a potent NSAID that can blunt the effects of ACE inhibitors and thiazides and, together with them, markedly increase the risk of acute kidney injury and hyperkalemia. The risk is greatest in older, volume-depleted or renally impaired patients.
What this interaction means in plain words
Captopril-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.
Captopril-hydrochlorothiazide belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
Inhibition of vasodilatory renal prostaglandins reduces renal perfusion and sodium excretion, while ACE inhibition and diuresis impair compensatory glomerular autoregulation.
What to do
Avoid in patients with renal impairment or volume depletion, and limit ketorolac to the shortest course possible. Monitor creatinine, potassium and blood pressure, and ensure hydration.
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 Captopril-hydrochlorothiazide
- Aliskiren + Captopril-hydrochlorothiazide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Aceclofenac + Captopril-hydrochlorothiazide Major
- Aldesleukin + Captopril-hydrochlorothiazide Major
- Amifostine + Captopril-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 Captopril-hydrochlorothiazide with Ketorolac?
MediHelp rates the interaction as major. Captopril-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 is a potent NSAID that can blunt the effects of ACE inhibitors and thiazides and, together with them, markedly increase the risk of acute kidney injury and hyperkalemia. The risk is greatest in older, volume-depleted or renally impaired patients.
How serious is the interaction between Captopril-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 in patients with renal impairment or volume depletion, and limit ketorolac to the shortest course possible. Monitor creatinine, potassium and blood pressure, and ensure hydration.
What other medicines interact with Captopril-hydrochlorothiazide?
MediHelp also lists interactions of Captopril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sacubitril / valsartan. The full list is on the Captopril-hydrochlorothiazide page.
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