Drug interactions
Enalapril-hydrochlorothiazide + Ketorolac intranasal
Severity: Major
Enalapril-hydrochlorothiazide and Ketorolac intranasal: 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 absorbed systemically after intranasal use and, like other NSAIDs, may reduce the antihypertensive effect of ACE inhibitors and thiazides. The triple combination of NSAID, ACE inhibitor and diuretic raises the risk of acute kidney injury, especially in dehydrated patients.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Ketorolac intranasal 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.
Why it happens
Inhibition of renal prostaglandin synthesis reduces glomerular perfusion when combined with ACE inhibition and diuresis.
What to do
Avoid or limit to short courses, ensure adequate hydration, and monitor serum creatinine, potassium and blood pressure; choose a non-NSAID analgesic in patients with renal impairment or volume depletion.
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 Enalapril-hydrochlorothiazide
- Aliskiren + Enalapril-hydrochlorothiazide Contraindicated
- Dofetilide + Enalapril-hydrochlorothiazide Contraindicated
- Enalapril-hydrochlorothiazide + Protein a column Contraindicated
- Enalapril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Amifostine + Enalapril-hydrochlorothiazide Major
- Amiloride + Enalapril-hydrochlorothiazide Major
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Ketorolac intranasal?
MediHelp rates the interaction as major. Enalapril-hydrochlorothiazide and Ketorolac intranasal 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 absorbed systemically after intranasal use and, like other NSAIDs, may reduce the antihypertensive effect of ACE inhibitors and thiazides. The triple combination of NSAID, ACE inhibitor and diuretic raises the risk of acute kidney injury, especially in dehydrated patients.
How serious is the interaction between Enalapril-hydrochlorothiazide and Ketorolac intranasal?
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 or limit to short courses, ensure adequate hydration, and monitor serum creatinine, potassium and blood pressure; choose a non-NSAID analgesic in patients with renal impairment or volume depletion.
What other medicines interact with Enalapril-hydrochlorothiazide?
MediHelp also lists interactions of Enalapril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Protein a column. The full list is on the Enalapril-hydrochlorothiazide page.
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