Drug interactions
Hydrochlorothiazide-irbesartan + Ketorolac intranasal
Severity: Moderate
Hydrochlorothiazide-irbesartan and Ketorolac intranasal: 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
NSAIDs such as ketorolac can blunt the antihypertensive effect of irbesartan and thiazides. In volume-depleted or elderly patients, or those with renal impairment, the combination of an ARB, a diuretic and an NSAID can precipitate acute kidney injury. Potassium may also rise.
What this interaction means in plain words
Hydrochlorothiazide-irbesartan and Ketorolac intranasal 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.
Why it happens
NSAIDs inhibit renal prostaglandin synthesis, causing sodium retention and reduced renal perfusion, which opposes diuretic and ARB effects and impairs glomerular filtration.
What to do
Monitor blood pressure, serum creatinine and potassium, and ensure adequate hydration. Keep ketorolac use as short as possible and avoid it in patients with renal impairment or volume depletion.
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 Hydrochlorothiazide-irbesartan
- Aliskiren + Hydrochlorothiazide-irbesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-irbesartan Contraindicated
- Hydrochlorothiazide-irbesartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-irbesartan Major
- Amifostine + Hydrochlorothiazide-irbesartan Major
- Amiloride + Hydrochlorothiazide-irbesartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-irbesartan with Ketorolac intranasal?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-irbesartan and Ketorolac intranasal 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. NSAIDs such as ketorolac can blunt the antihypertensive effect of irbesartan and thiazides. In volume-depleted or elderly patients, or those with renal impairment, the combination of an ARB, a diuretic and an NSAID can precipitate acute kidney injury. Potassium may also rise.
How serious is the interaction between Hydrochlorothiazide-irbesartan and Ketorolac intranasal?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure, serum creatinine and potassium, and ensure adequate hydration. Keep ketorolac use as short as possible and avoid it in patients with renal impairment or volume depletion.
What other medicines interact with Hydrochlorothiazide-irbesartan?
MediHelp also lists interactions of Hydrochlorothiazide-irbesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-irbesartan page.
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