Drug interactions
Hydrochlorothiazide-lisinopril + Tolfenamic acid
Severity: Moderate
Hydrochlorothiazide-lisinopril and Tolfenamic acid: 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 tolfenamic acid can blunt the antihypertensive effect of both lisinopril and hydrochlorothiazide and promote sodium and fluid retention. Combined with an ACE inhibitor and a diuretic, NSAIDs also raise the risk of acute kidney injury, particularly in volume-depleted or elderly patients, and may cause hyperkalemia.
What this interaction means in plain words
Hydrochlorothiazide-lisinopril and Tolfenamic acid 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.
Hydrochlorothiazide-lisinopril belongs to Cardiovascular; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal perfusion and natriuresis, opposing ACE inhibitor and diuretic effects and impairing potassium excretion.
What to do
Use the shortest NSAID course at the lowest dose and ensure adequate hydration. Monitor blood pressure, serum creatinine and potassium, especially in the first weeks.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Hydrochlorothiazide-lisinopril and Tolfenamic acid, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Tolfenamic acid
Frequently asked questions
Can I take Hydrochlorothiazide-lisinopril with Tolfenamic acid?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-lisinopril and Tolfenamic acid 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 tolfenamic acid can blunt the antihypertensive effect of both lisinopril and hydrochlorothiazide and promote sodium and fluid retention. Combined with an ACE inhibitor and a diuretic, NSAIDs also raise the risk of acute kidney injury, particularly in volume-depleted or elderly patients, and may cause hyperkalemia.
How serious is the interaction between Hydrochlorothiazide-lisinopril and Tolfenamic acid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the shortest NSAID course at the lowest dose and ensure adequate hydration. Monitor blood pressure, serum creatinine and potassium, especially in the first weeks.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
