Drug interactions
Ramipril + Tolmetin
Severity: Moderate
Ramipril and Tolmetin: 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
NSAIDs can blunt the blood pressure lowering effect of ACE inhibitors and, together with them, can impair kidney function. The risk is highest in older adults, volume-depleted patients, and those with existing renal impairment or heart failure.
What this interaction means in plain words
Ramipril and Tolmetin 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; Tolmetin belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces vasodilation of the afferent arteriole and sodium excretion, counteracting ACE inhibitor effects and lowering glomerular filtration under RAAS blockade.
What to do
Monitor blood pressure, serum creatinine and potassium after starting or changing the NSAID, and maintain hydration. Use the lowest effective NSAID dose for the shortest time, or choose paracetamol where suitable.
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 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 Ramipril
- Aliskiren + Ramipril Contraindicated
- Protein a column + Ramipril Contraindicated
- Ramipril + Sacubitril / valsartan Contraindicated
- Ramipril + Sacubitril-valsartan Contraindicated
- Amifostine + Ramipril Major
- Amiloride + Ramipril Major
Frequently asked questions
Can I take Ramipril with Tolmetin?
MediHelp rates the interaction as moderate. Ramipril and Tolmetin 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. NSAIDs can blunt the blood pressure lowering effect of ACE inhibitors and, together with them, can impair kidney function. The risk is highest in older adults, volume-depleted patients, and those with existing renal impairment or heart failure.
How serious is the interaction between Ramipril and Tolmetin?
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 after starting or changing the NSAID, and maintain hydration. Use the lowest effective NSAID dose for the shortest time, or choose paracetamol where suitable.
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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