Drug interactions
Citalopram + Ketorolac
Severity: Major
Citalopram 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
Combining ketorolac with an SSRI substantially increases the risk of gastrointestinal and other bleeding. Ketorolac carries a boxed warning for bleeding risk, making this combination particularly undesirable.
What this interaction means in plain words
Citalopram 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.
Citalopram belongs to Central Nervous System; Ketorolac belongs to Musculoskeletal.
Why it happens
SSRIs deplete platelet serotonin and impair platelet aggregation while ketorolac inhibits platelet COX-1 and damages gastric mucosa, producing additive bleeding risk.
What to do
Avoid the combination where possible, or limit ketorolac to a very short course. Consider gastroprotection with a proton pump inhibitor and monitor for signs of bleeding.
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 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?
MediHelp rates the interaction as major. Citalopram 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. Combining ketorolac with an SSRI substantially increases the risk of gastrointestinal and other bleeding. Ketorolac carries a boxed warning for bleeding risk, making this combination particularly undesirable.
How serious is the interaction between Citalopram 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, or limit ketorolac to a very short course. Consider gastroprotection with a proton pump inhibitor and monitor for signs of bleeding.
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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