Drug interactions
Tolmetin + Warfarin
Severity: Major
Tolmetin and Warfarin: 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 impair platelet function and damage the gastric mucosa, markedly raising the risk of serious bleeding in warfarin-treated patients. Some NSAIDs may also modestly alter the INR.
What this interaction means in plain words
Tolmetin and Warfarin 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.
Tolmetin belongs to Musculoskeletal; Warfarin belongs to Cardiovascular.
Why it happens
Additive hemostatic impairment from NSAID platelet inhibition and mucosal injury with vitamin K antagonist anticoagulation.
What to do
Avoid the combination where possible and use acetaminophen instead. If necessary, give the shortest course with gastroprotection and monitor INR and bleeding signs.
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
Other interactions of Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Frequently asked questions
Can I take Tolmetin with Warfarin?
MediHelp rates the interaction as major. Tolmetin and Warfarin 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 impair platelet function and damage the gastric mucosa, markedly raising the risk of serious bleeding in warfarin-treated patients. Some NSAIDs may also modestly alter the INR.
How serious is the interaction between Tolmetin and Warfarin?
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 the combination where possible and use acetaminophen instead. If necessary, give the shortest course with gastroprotection and monitor INR and bleeding signs.
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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