Drug interactions
Rivastigmine + Tolmetin
Severity: Moderate
Rivastigmine 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
Cholinesterase inhibitors increase gastric acid secretion and may raise the risk of ulcers, and NSAIDs add direct gastric mucosal injury. Combined use may therefore increase the chance of gastrointestinal ulceration and bleeding.
What this interaction means in plain words
Rivastigmine 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.
Rivastigmine belongs to Central Nervous System; Tolmetin belongs to Musculoskeletal.
Why it happens
Additive gastrointestinal effects: cholinergic stimulation of acid secretion plus NSAID inhibition of protective prostaglandins.
What to do
Monitor for dyspepsia, melena and other signs of GI bleeding, and consider gastroprotection such as a proton pump inhibitor in at-risk patients. Use the lowest effective tolmetin dose for the shortest time.
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 Rivastigmine
Frequently asked questions
Can I take Rivastigmine with Tolmetin?
MediHelp rates the interaction as moderate. Rivastigmine 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. Cholinesterase inhibitors increase gastric acid secretion and may raise the risk of ulcers, and NSAIDs add direct gastric mucosal injury. Combined use may therefore increase the chance of gastrointestinal ulceration and bleeding.
How serious is the interaction between Rivastigmine 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 for dyspepsia, melena and other signs of GI bleeding, and consider gastroprotection such as a proton pump inhibitor in at-risk patients. Use the lowest effective tolmetin dose for the shortest time.
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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