Drug interactions
Sacubitril-valsartan + Tolfenamic acid
Severity: Moderate
Sacubitril-valsartan 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, an NSAID, can reduce renal perfusion and prostaglandin-dependent sodium and potassium handling. With sacubitril-valsartan this increases the risk of kidney injury and hyperkalemia and may weaken blood pressure control.
What this interaction means in plain words
Sacubitril-valsartan 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.
Sacubitril-valsartan belongs to Cardiovascular; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandins combined with angiotensin receptor blockade reduces glomerular filtration and potassium excretion.
What to do
Avoid prolonged use; when needed, use the lowest effective dose and monitor creatinine, potassium and blood pressure, particularly in elderly or dehydrated patients.
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 Sacubitril-valsartan
- Aliskiren + Sacubitril-valsartan Contraindicated
- Benazepril + Sacubitril-valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Fosinopril + Sacubitril-valsartan Contraindicated
- Lisinopril + Sacubitril-valsartan Contraindicated
Other interactions of Tolfenamic acid
Frequently asked questions
Can I take Sacubitril-valsartan with Tolfenamic acid?
MediHelp rates the interaction as moderate. Sacubitril-valsartan 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, an NSAID, can reduce renal perfusion and prostaglandin-dependent sodium and potassium handling. With sacubitril-valsartan this increases the risk of kidney injury and hyperkalemia and may weaken blood pressure control.
How serious is the interaction between Sacubitril-valsartan 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: Avoid prolonged use; when needed, use the lowest effective dose and monitor creatinine, potassium and blood pressure, particularly in elderly or dehydrated patients.
What other medicines interact with Sacubitril-valsartan?
MediHelp also lists interactions of Sacubitril-valsartan with, for example, Aliskiren, Benazepril, Captopril. The full list is on the Sacubitril-valsartan page.
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