Drug interactions
Apixaban + Ketorolac
Severity: Contraindicated
Apixaban and Ketorolac: contraindicated 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 damages the gastric mucosa, which adds to the bleeding risk of apixaban. Serious gastrointestinal and other hemorrhages may result. Ketorolac labeling contraindicates its use with anticoagulants at therapeutic doses.
What this interaction means in plain words
Apixaban and Ketorolac are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Apixaban belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
Additive hemostatic impairment: NSAID antiplatelet effect and mucosal injury combined with factor Xa inhibition.
What to do
Avoid the combination and use a non-NSAID analgesic such as paracetamol. If an NSAID is absolutely needed, choose a different agent at the lowest dose with gastroprotection and bleeding monitoring.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Ketorolac
- Aceclofenac + Ketorolac Contraindicated
- Acemetacin + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac Contraindicated
- Argatroban + Ketorolac Contraindicated
- Aspirin / citric acid / sodium bicarbonate + Ketorolac Contraindicated
- Aspirin rectal + Ketorolac Contraindicated
Other interactions of Apixaban
- Apixaban + Dabigatran Contraindicated
- Apixaban + Defibrotide Contraindicated
- Apixaban + Edoxaban Contraindicated
- Apixaban + Mifepristone Contraindicated
- Abciximab + Apixaban Major
- Acalabrutinib + Apixaban Major
Frequently asked questions
Can I take Apixaban with Ketorolac?
MediHelp rates the interaction as contraindicated. Apixaban and Ketorolac are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ketorolac inhibits platelet function and damages the gastric mucosa, which adds to the bleeding risk of apixaban. Serious gastrointestinal and other hemorrhages may result. Ketorolac labeling contraindicates its use with anticoagulants at therapeutic doses.
How serious is the interaction between Apixaban and Ketorolac?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use a non-NSAID analgesic such as paracetamol. If an NSAID is absolutely needed, choose a different agent at the lowest dose with gastroprotection and bleeding monitoring.
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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