Drug interactions
Parecoxib + Tolmetin
Severity: Major
Parecoxib and Tolmetin: 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 a nonselective NSAID with another NSAID such as parecoxib adds no therapeutic benefit and increases the risk of gastrointestinal bleeding, ulceration, renal impairment and fluid retention. Cardiovascular and hyperkalemia risks are also additive.
What this interaction means in plain words
Parecoxib and Tolmetin 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
Duplicate cyclooxygenase inhibition causes additive gastrointestinal mucosal injury, platelet inhibition and reduced renal prostaglandin synthesis.
What to do
Avoid concurrent use of two NSAIDs and choose a single agent at the lowest effective dose. If an overlap is unavoidable, monitor renal function, potassium and signs of gastrointestinal bleeding.
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 Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin Major
Frequently asked questions
Can I take Parecoxib with Tolmetin?
MediHelp rates the interaction as major. Parecoxib and Tolmetin 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 a nonselective NSAID with another NSAID such as parecoxib adds no therapeutic benefit and increases the risk of gastrointestinal bleeding, ulceration, renal impairment and fluid retention. Cardiovascular and hyperkalemia risks are also additive.
How serious is the interaction between Parecoxib and Tolmetin?
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 NSAIDs and choose a single agent at the lowest effective dose. If an overlap is unavoidable, monitor renal function, potassium and signs of gastrointestinal bleeding.
What other medicines interact with Tolmetin?
MediHelp also lists interactions of Tolmetin with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Tolmetin page.
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