Drug interactions
Ibuprofen + Tolfenamic acid
Severity: Major
Ibuprofen and Tolfenamic acid: 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
Combining two NSAIDs adds no proven benefit and increases the risk of gastrointestinal ulceration and bleeding, renal impairment and cardiovascular events. Fluid retention and hyperkalemia are also more likely.
What this interaction means in plain words
Ibuprofen and Tolfenamic acid 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.
Ibuprofen belongs to Musculoskeletal; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
Additive inhibition of cyclooxygenase, reducing protective gastric and renal prostaglandins and impairing platelet function.
What to do
Avoid concurrent use of two systemic NSAIDs and use a single agent at the lowest effective dose. If analgesia is inadequate, add paracetamol rather than a second NSAID.
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 Ibuprofen
- Ibuprofen + Ketorolac Contraindicated
- Ibuprofen + Ketorolac intranasal Contraindicated
- Acemetacin + Ibuprofen Major
- Alteplase + Ibuprofen Major
- Amiloride + Ibuprofen Major
- Apixaban + Ibuprofen Major
Other interactions of Tolfenamic acid
Frequently asked questions
Can I take Ibuprofen with Tolfenamic acid?
MediHelp rates the interaction as major. Ibuprofen and Tolfenamic acid 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. Combining two NSAIDs adds no proven benefit and increases the risk of gastrointestinal ulceration and bleeding, renal impairment and cardiovascular events. Fluid retention and hyperkalemia are also more likely.
How serious is the interaction between Ibuprofen and Tolfenamic acid?
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 concurrent use of two systemic NSAIDs and use a single agent at the lowest effective dose. If analgesia is inadequate, add paracetamol rather than a second NSAID.
What other medicines interact with Ibuprofen?
MediHelp also lists interactions of Ibuprofen with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Ibuprofen page.
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