Drug interactions
Hydrochlorothiazide-olmesartan + Tolmetin
Severity: Moderate
Hydrochlorothiazide-olmesartan and Tolmetin: 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
Tolmetin can blunt the blood pressure lowering of olmesartan and hydrochlorothiazide. Combining an NSAID with an ARB and diuretic increases the risk of acute kidney injury and hyperkalemia, particularly in elderly or volume-depleted patients.
What this interaction means in plain words
Hydrochlorothiazide-olmesartan and Tolmetin 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-olmesartan belongs to Cardiovascular; Tolmetin belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal perfusion and sodium excretion, opposing antihypertensive effects and adding to renal hemodynamic risk.
What to do
Use the lowest effective dose for the shortest duration and keep the patient hydrated. Monitor blood pressure, creatinine and potassium.
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?
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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 Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin Major
Frequently asked questions
Can I take Hydrochlorothiazide-olmesartan with Tolmetin?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-olmesartan and Tolmetin 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. Tolmetin can blunt the blood pressure lowering of olmesartan and hydrochlorothiazide. Combining an NSAID with an ARB and diuretic increases the risk of acute kidney injury and hyperkalemia, particularly in elderly or volume-depleted patients.
How serious is the interaction between Hydrochlorothiazide-olmesartan and Tolmetin?
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 lowest effective dose for the shortest duration and keep the patient hydrated. Monitor blood pressure, 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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