Drug interactions
Amiloride + Ketorolac
Severity: Major
Amiloride and Ketorolac: 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 reduce renal prostaglandin synthesis and aldosterone-related potassium excretion, and amiloride is a potassium-sparing diuretic, so hyperkalemia can develop. Ketorolac may also reduce renal function and blunt diuretic effects, increasing risk of acute kidney injury.
What this interaction means in plain words
Amiloride and Ketorolac 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.
Amiloride belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
Additive potassium retention through ENaC blockade by amiloride and NSAID-induced hyporeninemic hypoaldosteronism with reduced renal perfusion.
What to do
Avoid the combination where possible, especially in renal impairment or the elderly; if used, check serum potassium and creatinine within the first days and periodically thereafter.
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 Ketorolac
- Aceclofenac + Ketorolac Contraindicated
- Acemetacin + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac Contraindicated
- Apixaban + Ketorolac Contraindicated
- Argatroban + Ketorolac Contraindicated
- Aspirin / citric acid / sodium bicarbonate + Ketorolac Contraindicated
Other interactions of Amiloride
- Amiloride + Eplerenone Contraindicated
- Amiloride + Spironolactone Contraindicated
- Amiloride + Triamterene Contraindicated
- Aceclofenac + Amiloride Major
- Acemetacin + Amiloride Major
- Amiloride + Amlodipine-benazepril Major
Frequently asked questions
Can I take Amiloride with Ketorolac?
MediHelp rates the interaction as major. Amiloride and Ketorolac 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 reduce renal prostaglandin synthesis and aldosterone-related potassium excretion, and amiloride is a potassium-sparing diuretic, so hyperkalemia can develop. Ketorolac may also reduce renal function and blunt diuretic effects, increasing risk of acute kidney injury.
How serious is the interaction between Amiloride and Ketorolac?
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, especially in renal impairment or the elderly; if used, check serum potassium and creatinine within the first days and periodically thereafter.
What other medicines interact with Ketorolac?
MediHelp also lists interactions of Ketorolac with, for example, Aceclofenac, Acemetacin, Acetylsalicylic acid. The full list is on the Ketorolac page.
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