Drug interactions
Tolmetin + Vorapaxar
Severity: Major
Tolmetin and Vorapaxar: 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
Vorapaxar is a PAR-1 antagonist antiplatelet agent and tolmetin reversibly inhibits platelet cyclooxygenase. Combined use increases the risk of bleeding, particularly gastrointestinal bleeding.
What this interaction means in plain words
Tolmetin and Vorapaxar 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
Additive antiplatelet effects via PAR-1 antagonism and COX inhibition, plus NSAID mucosal injury.
What to do
Avoid regular NSAID use where possible and choose an alternative analgesic such as paracetamol. If unavoidable, monitor for bleeding and consider gastroprotection.
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 Tolmetin with Vorapaxar?
MediHelp rates the interaction as major. Tolmetin and Vorapaxar 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. Vorapaxar is a PAR-1 antagonist antiplatelet agent and tolmetin reversibly inhibits platelet cyclooxygenase. Combined use increases the risk of bleeding, particularly gastrointestinal bleeding.
How serious is the interaction between Tolmetin and Vorapaxar?
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 and choose an alternative analgesic such as paracetamol. If unavoidable, monitor for bleeding and consider gastroprotection.
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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