Drug interactions
Hydrochlorothiazide-telmisartan + Ketorolac intranasal
Severity: Major
Hydrochlorothiazide-telmisartan 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 is an NSAID that can reduce the antihypertensive effect of telmisartan and hydrochlorothiazide. In combination with an ARB and a diuretic, NSAIDs raise the risk of acute kidney injury, particularly in older or volume-depleted patients, and may contribute to hyperkalemia.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan 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 prostaglandin synthesis reduces renal blood flow and sodium excretion, which together with ARB-mediated efferent dilation and diuretic volume loss impairs glomerular filtration.
What to do
Avoid the combination where possible, especially in elderly or dehydrated patients, and keep ketorolac courses short. Ensure adequate hydration and monitor blood pressure, serum 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-telmisartan
- Aliskiren + Hydrochlorothiazide-telmisartan Contraindicated
- Dofetilide + Hydrochlorothiazide-telmisartan Contraindicated
- Hydrochlorothiazide-telmisartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-telmisartan Major
- Amifostine + Hydrochlorothiazide-telmisartan Major
- Amiloride + Hydrochlorothiazide-telmisartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Ketorolac intranasal?
MediHelp rates the interaction as major. Hydrochlorothiazide-telmisartan 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 is an NSAID that can reduce the antihypertensive effect of telmisartan and hydrochlorothiazide. In combination with an ARB and a diuretic, NSAIDs raise the risk of acute kidney injury, particularly in older or volume-depleted patients, and may contribute to hyperkalemia.
How serious is the interaction between Hydrochlorothiazide-telmisartan 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, especially in elderly or dehydrated patients, and keep ketorolac courses short. Ensure adequate hydration and monitor blood pressure, serum creatinine and potassium.
What other medicines interact with Hydrochlorothiazide-telmisartan?
MediHelp also lists interactions of Hydrochlorothiazide-telmisartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-telmisartan page.
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