Drug interactions
Spironolactone + Tolmetin
Severity: Moderate
Spironolactone 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 reduce the diuretic and antihypertensive effect of spironolactone and increase the risk of hyperkalemia and acute kidney injury, particularly in older or renally impaired patients.
What this interaction means in plain words
Spironolactone 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.
Spironolactone belongs to Cardiovascular; Tolmetin belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandins lowers renal perfusion and aldosterone release, impairing potassium excretion additively with aldosterone antagonism.
What to do
Monitor serum potassium, creatinine and blood pressure after starting. Avoid in patients with renal impairment or heart failure with other risks.
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 Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
Frequently asked questions
Can I take Spironolactone with Tolmetin?
MediHelp rates the interaction as moderate. Spironolactone 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 reduce the diuretic and antihypertensive effect of spironolactone and increase the risk of hyperkalemia and acute kidney injury, particularly in older or renally impaired patients.
How serious is the interaction between Spironolactone 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 serum potassium, creatinine and blood pressure after starting. Avoid in patients with renal impairment or heart failure with other risks.
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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