Drug interactions
Hydrochlorothiazide-valsartan + Ketorolac intranasal
Severity: Major
Hydrochlorothiazide-valsartan 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 absorbed systemically after intranasal use and can reduce the antihypertensive effect of valsartan and hydrochlorothiazide. The triple effect of ARB, diuretic and NSAID raises the risk of acute kidney injury and hyperkalemia, especially with volume depletion or older age.
What this interaction means in plain words
Hydrochlorothiazide-valsartan 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 vasodilatory renal prostaglandins reduces glomerular perfusion when combined with angiotensin blockade and diuresis.
What to do
Avoid in dehydrated or renally impaired patients; otherwise limit ketorolac to the shortest course and 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-valsartan
- Aliskiren + Hydrochlorothiazide-valsartan Contraindicated
- Dofetilide + Hydrochlorothiazide-valsartan Contraindicated
- Hydrochlorothiazide-valsartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-valsartan Major
- Amifostine + Hydrochlorothiazide-valsartan Major
- Amiloride + Hydrochlorothiazide-valsartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-valsartan with Ketorolac intranasal?
MediHelp rates the interaction as major. Hydrochlorothiazide-valsartan 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 absorbed systemically after intranasal use and can reduce the antihypertensive effect of valsartan and hydrochlorothiazide. The triple effect of ARB, diuretic and NSAID raises the risk of acute kidney injury and hyperkalemia, especially with volume depletion or older age.
How serious is the interaction between Hydrochlorothiazide-valsartan 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 in dehydrated or renally impaired patients; otherwise limit ketorolac to the shortest course and monitor creatinine, potassium and blood pressure.
What other medicines interact with Hydrochlorothiazide-valsartan?
MediHelp also lists interactions of Hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-valsartan page.
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