Drug interactions
Digoxin + Tolmetin
Severity: Moderate
Digoxin 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
NSAIDs can reduce renal function and have been reported to raise serum digoxin concentrations, particularly in patients with renal impairment, older adults or neonates. Digoxin toxicity may follow, and NSAID-related hyperkalemia or fluid retention can complicate heart failure.
What this interaction means in plain words
Digoxin 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.
Digoxin belongs to Cardiovascular; Tolmetin belongs to Musculoskeletal.
Why it happens
NSAID-induced reduction in renal prostaglandin-dependent perfusion and glomerular filtration decreases digoxin clearance.
What to do
Monitor serum digoxin level, renal function and potassium when starting or stopping tolmetin. Reduce the digoxin dose if concentrations rise or toxicity signs appear.
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 Digoxin
- Digoxin + Lily of the valley Contraindicated
- Digoxin + Squill Contraindicated
- Adagrasib + Digoxin Major
- Amiodarone + Digoxin Major
- Amlodipine-hydrochlorothiazide-valsartan + Digoxin Major
- Amphotericin b deoxycholate + Digoxin Major
Frequently asked questions
Can I take Digoxin with Tolmetin?
MediHelp rates the interaction as moderate. Digoxin 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. NSAIDs can reduce renal function and have been reported to raise serum digoxin concentrations, particularly in patients with renal impairment, older adults or neonates. Digoxin toxicity may follow, and NSAID-related hyperkalemia or fluid retention can complicate heart failure.
How serious is the interaction between Digoxin 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: Monitor serum digoxin level, renal function and potassium when starting or stopping tolmetin. Reduce the digoxin dose if concentrations rise or toxicity signs appear.
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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