Drug interactions
Prasugrel + Tolmetin
Severity: Major
Prasugrel 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
Prasugrel is a potent antiplatelet agent, and NSAIDs add further platelet inhibition and gastrointestinal mucosal injury. Chronic NSAID use with prasugrel increases the risk of significant bleeding, especially gastrointestinal.
What this interaction means in plain words
Prasugrel 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.
Prasugrel belongs to Cardiovascular; Tolmetin belongs to Musculoskeletal.
Why it happens
Additive impairment of platelet function (P2Y12 blockade plus COX inhibition) and NSAID-related gastric mucosal damage.
What to do
Avoid regular NSAID use in patients taking prasugrel and use paracetamol for analgesia where possible. If an NSAID is needed, consider gastroprotection with a proton pump inhibitor and monitor for 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
Other interactions of Prasugrel
Frequently asked questions
Can I take Prasugrel with Tolmetin?
MediHelp rates the interaction as major. Prasugrel 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. Prasugrel is a potent antiplatelet agent, and NSAIDs add further platelet inhibition and gastrointestinal mucosal injury. Chronic NSAID use with prasugrel increases the risk of significant bleeding, especially gastrointestinal.
How serious is the interaction between Prasugrel 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 regular NSAID use in patients taking prasugrel and use paracetamol for analgesia where possible. If an NSAID is needed, consider gastroprotection with a proton pump inhibitor and monitor for 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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