Drug interactions
Hydrochlorothiazide-losartan + Tolfenamic acid
Severity: Moderate
Hydrochlorothiazide-losartan 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 losartan and hydrochlorothiazide. In patients who are older, volume-depleted or have renal impairment, the combination can cause acute kidney injury and raise potassium.
What this interaction means in plain words
Hydrochlorothiazide-losartan 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-losartan belongs to Cardiovascular; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis causes sodium and water retention and reduces glomerular perfusion, which is dependent on prostaglandins when the renin-angiotensin system and diuretics are acting.
What to do
Use the shortest NSAID course at the lowest dose and ensure adequate hydration. Monitor blood pressure, serum creatinine and potassium, particularly in the first weeks and in high-risk patients.
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-losartan 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 7 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
Other interactions of Tolfenamic acid
Frequently asked questions
Can I take Hydrochlorothiazide-losartan with Tolfenamic acid?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-losartan 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 losartan and hydrochlorothiazide. In patients who are older, volume-depleted or have renal impairment, the combination can cause acute kidney injury and raise potassium.
How serious is the interaction between Hydrochlorothiazide-losartan 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, particularly in the first weeks and in high-risk patients.
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.
