Drug interactions
Hydrochlorothiazide-olmesartan + Ketorolac
Severity: Major
Hydrochlorothiazide-olmesartan 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 with an ARB and a thiazide diuretic markedly raises the risk of acute kidney injury, especially in elderly or volume-depleted patients. It also reduces blood pressure control and may cause hyperkalemia.
What this interaction means in plain words
Hydrochlorothiazide-olmesartan 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-olmesartan belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandins reduces afferent arteriolar dilation, while ARB blocks efferent constriction and the diuretic reduces volume, impairing glomerular filtration.
What to do
Avoid ketorolac in patients on this combination, particularly if dehydrated or with renal impairment; choose an alternative analgesic such as paracetamol. If used, keep the course short and monitor 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?
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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
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-olmesartan with Ketorolac?
MediHelp rates the interaction as major. Hydrochlorothiazide-olmesartan 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 with an ARB and a thiazide diuretic markedly raises the risk of acute kidney injury, especially in elderly or volume-depleted patients. It also reduces blood pressure control and may cause hyperkalemia.
How serious is the interaction between Hydrochlorothiazide-olmesartan 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 ketorolac in patients on this combination, particularly if dehydrated or with renal impairment; choose an alternative analgesic such as paracetamol. If used, keep the course short and monitor creatinine and potassium.
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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