Drug interactions
Hydrochlorothiazide-olmesartan + Ketorolac intranasal
Severity: Major
Hydrochlorothiazide-olmesartan 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
Ketorolac, even intranasally, is systemically absorbed and as an NSAID can reduce the antihypertensive effect of olmesartan. Combined with an ARB and a thiazide diuretic, it raises the risk of acute kidney injury and hyperkalemia, particularly in older or volume-depleted patients.
What this interaction means in plain words
Hydrochlorothiazide-olmesartan 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 renal prostaglandins reduces glomerular perfusion, which with RAS blockade and diuresis impairs renal function and sodium and potassium handling.
What to do
Avoid the combination where possible, keep ketorolac courses short, and ensure adequate hydration. Monitor serum creatinine, potassium and blood pressure.
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-olmesartan
- Aliskiren + Hydrochlorothiazide-olmesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-olmesartan Contraindicated
- Hydrochlorothiazide-olmesartan + Sparsentan Contraindicated
- Acemetacin + Hydrochlorothiazide-olmesartan Major
- Amifostine + Hydrochlorothiazide-olmesartan Major
- Amiloride + Hydrochlorothiazide-olmesartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-olmesartan with Ketorolac intranasal?
MediHelp rates the interaction as major. Hydrochlorothiazide-olmesartan 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. Ketorolac, even intranasally, is systemically absorbed and as an NSAID can reduce the antihypertensive effect of olmesartan. Combined with an ARB and a thiazide diuretic, it raises the risk of acute kidney injury and hyperkalemia, particularly in older or volume-depleted patients.
How serious is the interaction between Hydrochlorothiazide-olmesartan 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 the combination where possible, keep ketorolac courses short, and ensure adequate hydration. Monitor serum creatinine, potassium and blood pressure.
What other medicines interact with Hydrochlorothiazide-olmesartan?
MediHelp also lists interactions of Hydrochlorothiazide-olmesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-olmesartan page.
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