Drug interactions
Heparin + Tolfenamic acid
Severity: Major
Heparin and Tolfenamic acid: 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
Tolfenamic acid is an NSAID that impairs platelet function and can irritate the gastrointestinal tract. Used with heparin it increases the likelihood of bleeding, particularly from the gut.
What this interaction means in plain words
Heparin and Tolfenamic acid 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.
Heparin belongs to Cardiovascular; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
Additive effect of NSAID-induced platelet inhibition and mucosal injury with heparin's anticoagulant action.
What to do
Prefer a non-NSAID analgesic such as paracetamol. If the combination is needed, use the lowest effective NSAID dose briefly and monitor for bleeding and hemoglobin.
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 Heparin
- Defibrotide + Heparin Contraindicated
- Heparin + Ketorolac Contraindicated
- Heparin + Oritavancin Contraindicated
- Acemetacin + Heparin Major
- Acetylsalicylic acid + Heparin Major
- Alteplase + Heparin Major
Other interactions of Tolfenamic acid
Frequently asked questions
Can I take Heparin with Tolfenamic acid?
MediHelp rates the interaction as major. Heparin and Tolfenamic acid 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. Tolfenamic acid is an NSAID that impairs platelet function and can irritate the gastrointestinal tract. Used with heparin it increases the likelihood of bleeding, particularly from the gut.
How serious is the interaction between Heparin and Tolfenamic acid?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-NSAID analgesic such as paracetamol. If the combination is needed, use the lowest effective NSAID dose briefly and monitor for bleeding and hemoglobin.
What other medicines interact with Heparin?
MediHelp also lists interactions of Heparin with, for example, Defibrotide, Ketorolac, Oritavancin. The full list is on the Heparin page.
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