Drug interactions
Fosinopril-hydrochlorothiazide + Tolmetin
Severity: Moderate
Fosinopril-hydrochlorothiazide 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
Tolmetin can blunt the blood pressure lowering effect of fosinopril and hydrochlorothiazide. Together with an ACE inhibitor and a diuretic it can also precipitate acute kidney injury, particularly in older, volume-depleted or renally impaired patients.
What this interaction means in plain words
Fosinopril-hydrochlorothiazide 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.
Fosinopril-hydrochlorothiazide belongs to Cardiovascular; Tolmetin belongs to Musculoskeletal.
Why it happens
NSAID inhibition of cyclooxygenase reduces vasodilatory renal prostaglandins, causing sodium and water retention and reduced glomerular perfusion that opposes ACE inhibitor and diuretic effects.
What to do
Prefer paracetamol or the lowest effective NSAID dose for the shortest time. Monitor blood pressure, serum creatinine and potassium, and maintain hydration.
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 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 Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin Major
Frequently asked questions
Can I take Fosinopril-hydrochlorothiazide with Tolmetin?
MediHelp rates the interaction as moderate. Fosinopril-hydrochlorothiazide 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. Tolmetin can blunt the blood pressure lowering effect of fosinopril and hydrochlorothiazide. Together with an ACE inhibitor and a diuretic it can also precipitate acute kidney injury, particularly in older, volume-depleted or renally impaired patients.
How serious is the interaction between Fosinopril-hydrochlorothiazide 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: Prefer paracetamol or the lowest effective NSAID dose for the shortest time. Monitor blood pressure, serum creatinine and potassium, and maintain hydration.
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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