Drug interactions
Sacubitril / valsartan + Tolmetin
Severity: Major
Sacubitril / valsartan and Tolmetin: major 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 reduce the antihypertensive effect of sacubitril/valsartan and, in elderly or volume-depleted patients, may worsen renal function. Hyperkalemia may also be more likely.
What this interaction means in plain words
Sacubitril / valsartan and Tolmetin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
NSAIDs inhibit vasodilatory renal prostaglandins, reducing glomerular perfusion on top of angiotensin receptor blockade, while impairing potassium excretion and promoting fluid retention.
What to do
Avoid regular NSAID use where possible; if needed, monitor blood pressure, serum creatinine and potassium, and ensure adequate hydration. Stop the NSAID if renal function deteriorates.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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
Frequently asked questions
Can I take Sacubitril / valsartan with Tolmetin?
MediHelp rates the interaction as major. Sacubitril / valsartan and Tolmetin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. NSAIDs can reduce the antihypertensive effect of sacubitril/valsartan and, in elderly or volume-depleted patients, may worsen renal function. Hyperkalemia may also be more likely.
How serious is the interaction between Sacubitril / valsartan and Tolmetin?
MediHelp rates it major, 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; if needed, monitor blood pressure, serum creatinine and potassium, and ensure adequate hydration. Stop the NSAID if renal function deteriorates.
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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