Drug interactions
Diclofenac + Tolfenamic acid
Severity: Major
Diclofenac and Tolfenamic acid: major interaction.
Last updated Sources: US FDA label
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 two NSAIDs gives no added benefit and increases the risk of gastrointestinal bleeding, renal injury and cardiovascular events.
What this interaction means in plain words
Diclofenac 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.
Diclofenac belongs to Musculoskeletal; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
Duplicate cyclooxygenase inhibition causes additive mucosal, platelet and renal prostaglandin effects.
What to do
Avoid using two systemic NSAIDs together; use a single agent at the lowest effective dose.
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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References
Other interactions of Diclofenac
- Diclofenac + Ketorolac Contraindicated
- Diclofenac + Ketorolac intranasal Contraindicated
- Aceclofenac + Diclofenac Major
- Acemetacin + Diclofenac Major
- Alteplase + Diclofenac Major
- Amiloride + Diclofenac Major
Other interactions of Tolfenamic acid
Frequently asked questions
Can I take Diclofenac with Tolfenamic acid?
MediHelp rates the interaction as major. Diclofenac 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. Combining two NSAIDs gives no added benefit and increases the risk of gastrointestinal bleeding, renal injury and cardiovascular events.
How serious is the interaction between Diclofenac 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 using two systemic NSAIDs together; use a single agent at the lowest effective dose.
What other medicines interact with Diclofenac?
MediHelp also lists interactions of Diclofenac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Diclofenac page.
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