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Drug interactions

Hydrochlorothiazide-irbesartan + Ketorolac

Severity: Major

Hydrochlorothiazide-irbesartan 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 reduce the antihypertensive effect of thiazides and ARBs. Together they markedly raise the risk of acute kidney injury and hyperkalemia, particularly in volume-depleted or elderly patients.

What this interaction means in plain words

Hydrochlorothiazide-irbesartan 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.

Hydrochlorothiazide-irbesartan belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.

Evidence level: High

Why it happens

Prostaglandin inhibition reduces renal blood flow and sodium excretion while ARB and diuretic impair compensatory autoregulation.

What to do

Avoid ketorolac in patients on this combination where possible, especially with dehydration or renal impairment; if used, limit to short courses 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Hydrochlorothiazide-irbesartan with Ketorolac?

MediHelp rates the interaction as major. Hydrochlorothiazide-irbesartan 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 reduce the antihypertensive effect of thiazides and ARBs. Together they markedly raise the risk of acute kidney injury and hyperkalemia, particularly in volume-depleted or elderly patients.

How serious is the interaction between Hydrochlorothiazide-irbesartan 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 ketorolac in patients on this combination where possible, especially with dehydration or renal impairment; if used, limit to short courses and monitor creatinine and potassium.

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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