Drug interactions
Bivalirudin + Ketorolac
Severity: Major
Bivalirudin 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
Bivalirudin is a direct thrombin inhibitor, and ketorolac impairs platelet function and can cause GI bleeding. The combination raises bleeding risk substantially.
What this interaction means in plain words
Bivalirudin 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.
Why it happens
Additive hemostatic impairment through direct thrombin inhibition and NSAID antiplatelet effect.
What to do
Avoid ketorolac in patients receiving bivalirudin; if used, monitor closely for bleeding and hemoglobin.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Bivalirudin and Ketorolac, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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
Frequently asked questions
Can I take Bivalirudin with Ketorolac?
MediHelp rates the interaction as major. Bivalirudin 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. Bivalirudin is a direct thrombin inhibitor, and ketorolac impairs platelet function and can cause GI bleeding. The combination raises bleeding risk substantially.
How serious is the interaction between Bivalirudin 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 ketorolac in patients receiving bivalirudin; if used, monitor closely for bleeding and hemoglobin.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
