Drug interactions
Hydrochlorothiazide-lisinopril + Tolmetin
Severity: Moderate
Hydrochlorothiazide-lisinopril and Tolmetin: 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
Tolmetin, an NSAID, can reduce the blood pressure lowering effect of lisinopril and hydrochlorothiazide and cause fluid retention. The triple effect of an NSAID, ACE inhibitor and diuretic raises the risk of acute kidney injury and hyperkalemia, especially with dehydration or existing renal impairment.
What this interaction means in plain words
Hydrochlorothiazide-lisinopril and Tolmetin 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; Tolmetin belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandins reduces renal blood flow and sodium excretion, antagonizing ACE inhibitor and diuretic actions.
What to do
Avoid prolonged use and keep patients well hydrated. Monitor blood pressure, serum creatinine and potassium, and stop the NSAID if renal function declines.
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-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 Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin Major
Frequently asked questions
Can I take Hydrochlorothiazide-lisinopril with Tolmetin?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-lisinopril and Tolmetin 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. Tolmetin, an NSAID, can reduce the blood pressure lowering effect of lisinopril and hydrochlorothiazide and cause fluid retention. The triple effect of an NSAID, ACE inhibitor and diuretic raises the risk of acute kidney injury and hyperkalemia, especially with dehydration or existing renal impairment.
How serious is the interaction between Hydrochlorothiazide-lisinopril and Tolmetin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid prolonged use and keep patients well hydrated. Monitor blood pressure, serum creatinine and potassium, and stop the NSAID if renal function declines.
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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