Drug interactions
Alteplase + Ketorolac intranasal
Severity: Major
Alteplase and Ketorolac intranasal: 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
Ketorolac inhibits platelet function and carries a bleeding warning; intranasal dosing achieves systemic levels, and with alteplase bleeding risk rises. Ketorolac labeling lists recent thrombolysis-related bleeding risk as a concern.
What this interaction means in plain words
Alteplase and Ketorolac intranasal 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
Reversible platelet COX inhibition adds to fibrinolysis, increasing hemorrhage risk.
What to do
Avoid ketorolac around thrombolytic therapy and choose a non-NSAID analgesic such as paracetamol. Monitor for bleeding if unavoidable.
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 Alteplase
- Alteplase + Defibrotide Contraindicated
- Alteplase + Reteplase Contraindicated
- Alteplase + Tenecteplase Contraindicated
- Acetylsalicylic acid + Alteplase Major
- Alteplase + Apixaban Major
- Alteplase + Argatroban Major
Frequently asked questions
Can I take Alteplase with Ketorolac intranasal?
MediHelp rates the interaction as major. Alteplase and Ketorolac intranasal 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. Ketorolac inhibits platelet function and carries a bleeding warning; intranasal dosing achieves systemic levels, and with alteplase bleeding risk rises. Ketorolac labeling lists recent thrombolysis-related bleeding risk as a concern.
How serious is the interaction between Alteplase and Ketorolac intranasal?
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 ketorolac around thrombolytic therapy and choose a non-NSAID analgesic such as paracetamol. Monitor for bleeding if unavoidable.
What other medicines interact with Alteplase?
MediHelp also lists interactions of Alteplase with, for example, Defibrotide, Reteplase, Tenecteplase. The full list is on the Alteplase page.
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