Drug interactions
Escitalopram + Tolmetin
Severity: Moderate
Escitalopram 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
An SSRI taken with an NSAID increases the risk of upper gastrointestinal bleeding beyond either drug alone. Older patients and those with ulcer history are at highest risk.
What this interaction means in plain words
Escitalopram 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.
Escitalopram belongs to Central Nervous System; Tolmetin belongs to Musculoskeletal.
Why it happens
SSRI-mediated depletion of platelet serotonin impairs aggregation, adding to NSAID COX-1 inhibition and gastric mucosal injury.
What to do
Use the lowest effective NSAID dose for the shortest duration and consider a proton pump inhibitor. Monitor for melena, hematemesis and anemia.
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 Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Escitalopram with Tolmetin?
MediHelp rates the interaction as moderate. Escitalopram 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. An SSRI taken with an NSAID increases the risk of upper gastrointestinal bleeding beyond either drug alone. Older patients and those with ulcer history are at highest risk.
How serious is the interaction between Escitalopram 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: Use the lowest effective NSAID dose for the shortest duration and consider a proton pump inhibitor. Monitor for melena, hematemesis and anemia.
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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