Drug interactions
Fosinopril-hydrochlorothiazide + Ketorolac intranasal
Severity: Major
Fosinopril-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 a potent NSAID that is systemically absorbed from the nasal route. Combined with an ACE inhibitor and a thiazide it can cause acute kidney injury and reduce blood pressure control, particularly in volume-depleted patients.
What this interaction means in plain words
Fosinopril-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 prostaglandins reduces afferent arteriolar dilation, which together with ACE inhibition and diuresis impairs glomerular filtration.
What to do
Limit ketorolac to the shortest course possible and ensure hydration; monitor creatinine, potassium and blood pressure, or use a non-NSAID analgesic.
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 Fosinopril-hydrochlorothiazide
- Aliskiren + Fosinopril-hydrochlorothiazide Contraindicated
- Dofetilide + Fosinopril-hydrochlorothiazide Contraindicated
- Fosinopril-hydrochlorothiazide + Protein a column Contraindicated
- Fosinopril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Aldesleukin + Fosinopril-hydrochlorothiazide Major
- Amifostine + Fosinopril-hydrochlorothiazide Major
Frequently asked questions
Can I take Fosinopril-hydrochlorothiazide with Ketorolac intranasal?
MediHelp rates the interaction as major. Fosinopril-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 a potent NSAID that is systemically absorbed from the nasal route. Combined with an ACE inhibitor and a thiazide it can cause acute kidney injury and reduce blood pressure control, particularly in volume-depleted patients.
How serious is the interaction between Fosinopril-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: Limit ketorolac to the shortest course possible and ensure hydration; monitor creatinine, potassium and blood pressure, or use a non-NSAID analgesic.
What other medicines interact with Fosinopril-hydrochlorothiazide?
MediHelp also lists interactions of Fosinopril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Protein a column. The full list is on the Fosinopril-hydrochlorothiazide page.
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