Drug interactions
Hydrochlorothiazide-lisinopril + Ketorolac
Severity: Major
Hydrochlorothiazide-lisinopril 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 with notable nephrotoxicity, and with a diuretic and ACE inhibitor it considerably raises the risk of acute kidney injury and hyperkalemia. It can also reduce the antihypertensive effect.
What this interaction means in plain words
Hydrochlorothiazide-lisinopril 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-lisinopril belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
Potent NSAID inhibition of renal prostaglandins reduces renal blood flow, especially when volume is depleted and the renin-angiotensin system is blocked.
What to do
Avoid if possible, particularly in volume-depleted or renally impaired patients, and limit ketorolac to the shortest course. Monitor creatinine, potassium and blood pressure.
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 Hydrochlorothiazide-lisinopril
- Dofetilide + Hydrochlorothiazide-lisinopril Contraindicated
- Hydrochlorothiazide-lisinopril + Sacubitril / valsartan Contraindicated
- Amifostine + Hydrochlorothiazide-lisinopril Major
- Amiloride + Hydrochlorothiazide-lisinopril Major
- Benazepril + Hydrochlorothiazide-lisinopril Major
- Bendroflumethiazide + Hydrochlorothiazide-lisinopril 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 Hydrochlorothiazide-lisinopril with Ketorolac?
MediHelp rates the interaction as major. Hydrochlorothiazide-lisinopril 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 with notable nephrotoxicity, and with a diuretic and ACE inhibitor it considerably raises the risk of acute kidney injury and hyperkalemia. It can also reduce the antihypertensive effect.
How serious is the interaction between Hydrochlorothiazide-lisinopril 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 if possible, particularly in volume-depleted or renally impaired patients, and limit ketorolac to the shortest course. Monitor creatinine, potassium and blood pressure.
What other medicines interact with Hydrochlorothiazide-lisinopril?
MediHelp also lists interactions of Hydrochlorothiazide-lisinopril with, for example, Dofetilide, Sacubitril / valsartan, Amifostine. The full list is on the Hydrochlorothiazide-lisinopril page.
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