Drug interactions
Citalopram + Tolmetin
Severity: Moderate
Citalopram and Tolmetin: 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
Combining an NSAID with an SSRI raises the risk of gastrointestinal bleeding well above that seen with either drug alone. The risk is greatest in older patients and in those with prior ulcer disease or on other agents affecting hemostasis.
What this interaction means in plain words
Citalopram and Tolmetin 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.
Citalopram belongs to Central Nervous System; Tolmetin belongs to Musculoskeletal.
Why it happens
SSRIs deplete platelet serotonin and impair aggregation while tolmetin inhibits platelet COX-1 and damages gastric mucosa, giving additive bleeding risk.
What to do
Avoid the combination where possible, or use the lowest effective NSAID dose for the shortest time and consider adding a proton pump inhibitor. Monitor for melena, hematemesis and falling hemoglobin.
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 Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin Major
Other interactions of Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Frequently asked questions
Can I take Citalopram with Tolmetin?
MediHelp rates the interaction as moderate. Citalopram and Tolmetin 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. Combining an NSAID with an SSRI raises the risk of gastrointestinal bleeding well above that seen with either drug alone. The risk is greatest in older patients and in those with prior ulcer disease or on other agents affecting hemostasis.
How serious is the interaction between Citalopram and Tolmetin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible, or use the lowest effective NSAID dose for the shortest time and consider adding a proton pump inhibitor. Monitor for melena, hematemesis and falling hemoglobin.
What other medicines interact with Tolmetin?
MediHelp also lists interactions of Tolmetin with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Tolmetin page.
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