Drug interactions
Hydrochlorothiazide-losartan + Ketorolac intranasal
Severity: Major
Hydrochlorothiazide-losartan and Ketorolac intranasal: 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
NSAIDs such as ketorolac reduce renal prostaglandin synthesis, which can blunt the antihypertensive effect of losartan and hydrochlorothiazide. The combination of an NSAID, an ARB and a diuretic also increases the risk of acute kidney injury, especially with volume depletion, and may cause hyperkalemia.
What this interaction means in plain words
Hydrochlorothiazide-losartan and Ketorolac intranasal 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.
Why it happens
NSAID inhibition of prostaglandin-mediated renal vasodilation reduces renal perfusion and antagonizes antihypertensive and diuretic effects.
What to do
Avoid or limit ketorolac to the shortest possible course and ensure adequate hydration. Monitor blood pressure, serum 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Hydrochlorothiazide-losartan and Ketorolac intranasal, 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-losartan
- Aliskiren + Hydrochlorothiazide-losartan Contraindicated
- Dofetilide + Hydrochlorothiazide-losartan Contraindicated
- Hydrochlorothiazide-losartan + Sparsentan Contraindicated
- Aceclofenac + Hydrochlorothiazide-losartan Major
- Aldesleukin + Hydrochlorothiazide-losartan Major
- Amifostine + Hydrochlorothiazide-losartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-losartan with Ketorolac intranasal?
MediHelp rates the interaction as major. Hydrochlorothiazide-losartan and Ketorolac intranasal 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. NSAIDs such as ketorolac reduce renal prostaglandin synthesis, which can blunt the antihypertensive effect of losartan and hydrochlorothiazide. The combination of an NSAID, an ARB and a diuretic also increases the risk of acute kidney injury, especially with volume depletion, and may cause hyperkalemia.
How serious is the interaction between Hydrochlorothiazide-losartan and Ketorolac intranasal?
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 or limit ketorolac to the shortest possible course and ensure adequate hydration. Monitor blood pressure, serum creatinine and potassium.
What other medicines interact with Hydrochlorothiazide-losartan?
MediHelp also lists interactions of Hydrochlorothiazide-losartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-losartan 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.
