Drug interactions
Hydrochlorothiazide-losartan + Ketorolac
Severity: Major
Hydrochlorothiazide-losartan 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 can reduce the antihypertensive effect of losartan and hydrochlorothiazide. Together with a diuretic and ARB it carries a substantial risk of acute kidney injury and hyperkalemia, especially with volume depletion.
What this interaction means in plain words
Hydrochlorothiazide-losartan 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-losartan belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal perfusion and sodium excretion, impairing glomerular filtration when combined with ARB and diuretic.
What to do
Avoid or limit ketorolac to a brief course with adequate hydration. Monitor creatinine, potassium and blood pressure, or use an alternative analgesic such as paracetamol.
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-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
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-losartan with Ketorolac?
MediHelp rates the interaction as major. Hydrochlorothiazide-losartan 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 can reduce the antihypertensive effect of losartan and hydrochlorothiazide. Together with a diuretic and ARB it carries a substantial risk of acute kidney injury and hyperkalemia, especially with volume depletion.
How serious is the interaction between Hydrochlorothiazide-losartan 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 or limit ketorolac to a brief course with adequate hydration. Monitor creatinine, potassium and blood pressure, or use an alternative analgesic such as paracetamol.
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.
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