Drug interactions
Sacubitril-valsartan + Tolmetin
Severity: Moderate
Sacubitril-valsartan 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
Tolmetin, an NSAID, can impair renal function and reduce the antihypertensive effect of sacubitril-valsartan. Hyperkalemia and acute kidney injury are more likely in elderly or volume-depleted patients.
What this interaction means in plain words
Sacubitril-valsartan 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.
Sacubitril-valsartan belongs to Cardiovascular; Tolmetin belongs to Musculoskeletal.
Why it happens
NSAID inhibition of vasodilatory renal prostaglandins together with angiotensin receptor blockade reduces renal perfusion and potassium excretion.
What to do
Avoid regular NSAID use where possible; otherwise use the lowest dose briefly and monitor creatinine, potassium and blood pressure.
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 Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin Major
Frequently asked questions
Can I take Sacubitril-valsartan with Tolmetin?
MediHelp rates the interaction as moderate. Sacubitril-valsartan 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. Tolmetin, an NSAID, can impair renal function and reduce the antihypertensive effect of sacubitril-valsartan. Hyperkalemia and acute kidney injury are more likely in elderly or volume-depleted patients.
How serious is the interaction between Sacubitril-valsartan 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: Avoid regular NSAID use where possible; otherwise use the lowest dose briefly and monitor creatinine, potassium and blood pressure.
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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