Drug interactions
Naproxen + Tolfenamic acid
Severity: Major
Naproxen 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
Taking two NSAIDs together provides no added benefit and increases the risk of gastrointestinal bleeding, ulceration and renal toxicity. Fluid retention and hyperkalemia may also be additive.
What this interaction means in plain words
Naproxen 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.
Naproxen belongs to Musculoskeletal; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
Duplicate cyclooxygenase inhibition with additive loss of gastric mucosal protection, platelet inhibition and renal prostaglandin effects.
What to do
Avoid combining NSAIDs and use a single agent at the lowest effective dose. Monitor for GI bleeding and renal function if overlap cannot be avoided.
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 Naproxen
- Ketorolac intranasal + Naproxen Contraindicated
- Ketorolac + Naproxen Contraindicated
- Aceclofenac + Naproxen Major
- Acemetacin + Naproxen Major
- Acetylsalicylic acid + Naproxen Major
- Alteplase + Naproxen Major
Other interactions of Tolfenamic acid
Frequently asked questions
Can I take Naproxen with Tolfenamic acid?
MediHelp rates the interaction as major. Naproxen 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. Taking two NSAIDs together provides no added benefit and increases the risk of gastrointestinal bleeding, ulceration and renal toxicity. Fluid retention and hyperkalemia may also be additive.
How serious is the interaction between Naproxen 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 combining NSAIDs and use a single agent at the lowest effective dose. Monitor for GI bleeding and renal function if overlap cannot be avoided.
What other medicines interact with Naproxen?
MediHelp also lists interactions of Naproxen with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Naproxen page.
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