Drug interactions
Ramipril + Tolfenamic acid
Severity: Moderate
Ramipril and Tolfenamic acid: moderate 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
Tolfenamic acid may weaken the blood pressure control achieved with ramipril. Combined use also raises the risk of renal impairment and hyperkalemia, particularly in volume-depleted or older patients.
What this interaction means in plain words
Ramipril and Tolfenamic acid can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Ramipril belongs to Cardiovascular; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
NSAID inhibition of prostaglandin synthesis causes sodium retention and reduced renal perfusion, opposing ACE inhibitor effects.
What to do
Monitor blood pressure, serum creatinine and potassium, and maintain hydration. Limit NSAID use to the lowest dose and shortest duration.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ramipril
- Aliskiren + Ramipril Contraindicated
- Protein a column + Ramipril Contraindicated
- Ramipril + Sacubitril / valsartan Contraindicated
- Ramipril + Sacubitril-valsartan Contraindicated
- Amifostine + Ramipril Major
- Amiloride + Ramipril Major
Other interactions of Tolfenamic acid
Frequently asked questions
Can I take Ramipril with Tolfenamic acid?
MediHelp rates the interaction as moderate. Ramipril and Tolfenamic acid can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Tolfenamic acid may weaken the blood pressure control achieved with ramipril. Combined use also raises the risk of renal impairment and hyperkalemia, particularly in volume-depleted or older patients.
How serious is the interaction between Ramipril and Tolfenamic acid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure, serum creatinine and potassium, and maintain hydration. Limit NSAID use to the lowest dose and shortest duration.
What other medicines interact with Ramipril?
MediHelp also lists interactions of Ramipril with, for example, Aliskiren, Protein a column, Sacubitril / valsartan. The full list is on the Ramipril page.
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