Drug interactions
Hydrochlorothiazide-telmisartan + Ketorolac
Severity: Major
Hydrochlorothiazide-telmisartan 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 is a potent NSAID that can blunt the antihypertensive effect of telmisartan and hydrochlorothiazide. It carries a notable risk of acute kidney injury and hyperkalemia with this combination, especially in dehydrated or elderly patients.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan 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-telmisartan belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal perfusion and sodium excretion, while ARB blockade removes efferent arteriolar compensation.
What to do
Avoid the combination in patients with volume depletion or renal impairment, and keep ketorolac courses short. Monitor 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-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
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-telmisartan with Ketorolac?
MediHelp rates the interaction as major. Hydrochlorothiazide-telmisartan 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 is a potent NSAID that can blunt the antihypertensive effect of telmisartan and hydrochlorothiazide. It carries a notable risk of acute kidney injury and hyperkalemia with this combination, especially in dehydrated or elderly patients.
How serious is the interaction between Hydrochlorothiazide-telmisartan 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 the combination in patients with volume depletion or renal impairment, and keep ketorolac courses short. Monitor creatinine, potassium and blood pressure.
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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