Drug interactions
Clopidogrel + Ketorolac
Severity: Major
Clopidogrel 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
Both drugs inhibit platelet function, and ketorolac also injures the gastric mucosa, so concurrent use markedly increases bleeding risk, particularly gastrointestinal bleeding. Ketorolac labeling advises against use with other antiplatelet agents.
What this interaction means in plain words
Clopidogrel 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.
Clopidogrel belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
Additive antiplatelet effects from P2Y12 inhibition and COX-1 inhibition, plus NSAID-induced mucosal injury.
What to do
Avoid ketorolac in patients taking clopidogrel and use a non-NSAID analgesic; if unavoidable, limit duration and monitor for bleeding with gastroprotection.
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 Clopidogrel
Frequently asked questions
Can I take Clopidogrel with Ketorolac?
MediHelp rates the interaction as major. Clopidogrel 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. Both drugs inhibit platelet function, and ketorolac also injures the gastric mucosa, so concurrent use markedly increases bleeding risk, particularly gastrointestinal bleeding. Ketorolac labeling advises against use with other antiplatelet agents.
How serious is the interaction between Clopidogrel 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 taking clopidogrel and use a non-NSAID analgesic; if unavoidable, limit duration and monitor for bleeding with gastroprotection.
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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