Drug interactions
Citalopram + Ketorolac intranasal
Severity: Major
Citalopram and Ketorolac intranasal: major interaction.
Last updated Sources: UK SmPC
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
SSRIs impair platelet aggregation and ketorolac is an NSAID that irritates the gastric mucosa and inhibits platelets. Together they substantially increase the risk of gastrointestinal and other bleeding.
What this interaction means in plain words
Citalopram 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
Additive platelet dysfunction (SSRI serotonin depletion, NSAID COX-1 inhibition) with NSAID gastric mucosal injury.
What to do
Avoid if possible, and limit ketorolac duration to the labeled short course. Consider gastroprotection and monitor for GI bleeding in high-risk patients.
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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References
- Cipramil 20 mg film-coated tablets - SmPC sections 4.3/4.5 (class statement: non steroidal anti-inflammatory drugs (NSAIDs); "medicinal products that affect the platelet function, such as non steroidal anti-inflammatory drugs (NSAIDs), acetylsalicylic acid, dipyridamole, and ticlopidin") — electronic medicines compendium (UK SmPC)
Other interactions of Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Frequently asked questions
Can I take Citalopram with Ketorolac intranasal?
MediHelp rates the interaction as major. Citalopram 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. SSRIs impair platelet aggregation and ketorolac is an NSAID that irritates the gastric mucosa and inhibits platelets. Together they substantially increase the risk of gastrointestinal and other bleeding.
How serious is the interaction between Citalopram 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 if possible, and limit ketorolac duration to the labeled short course. Consider gastroprotection and monitor for GI bleeding in high-risk patients.
What other medicines interact with Citalopram?
MediHelp also lists interactions of Citalopram with, for example, Cisapride, Dronedarone, Escitalopram. The full list is on the Citalopram page.
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