Drug interactions
Fosinopril-hydrochlorothiazide + Ketorolac
Severity: Major
Fosinopril-hydrochlorothiazide and Ketorolac: 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 can substantially reduce renal perfusion and antagonize the antihypertensive effect of fosinopril and hydrochlorothiazide. The combination carries a notable risk of acute kidney injury and hyperkalemia, especially in dehydrated or older patients.
What this interaction means in plain words
Fosinopril-hydrochlorothiazide and Ketorolac 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.
Fosinopril-hydrochlorothiazide belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
Potent inhibition of vasodilatory renal prostaglandins reduces glomerular filtration and sodium excretion, compounding the hemodynamic effects of ACE inhibition and diuresis.
What to do
Avoid where possible and choose a different analgesic. If ketorolac is essential, limit it to a short course (no more than five days), ensure hydration, and monitor creatinine and potassium.
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
Other interactions of Ketorolac
- Aceclofenac + Ketorolac Contraindicated
- Acemetacin + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac Contraindicated
- Apixaban + Ketorolac Contraindicated
- Argatroban + Ketorolac Contraindicated
- Aspirin / citric acid / sodium bicarbonate + Ketorolac Contraindicated
Frequently asked questions
Can I take Fosinopril-hydrochlorothiazide with Ketorolac?
MediHelp rates the interaction as major. Fosinopril-hydrochlorothiazide and Ketorolac 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 can substantially reduce renal perfusion and antagonize the antihypertensive effect of fosinopril and hydrochlorothiazide. The combination carries a notable risk of acute kidney injury and hyperkalemia, especially in dehydrated or older patients.
How serious is the interaction between Fosinopril-hydrochlorothiazide and Ketorolac?
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 where possible and choose a different analgesic. If ketorolac is essential, limit it to a short course (no more than five days), ensure hydration, and monitor creatinine and potassium.
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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