Drug interactions
Cortisone + Ketorolac
Severity: Major
Cortisone and Ketorolac: major interaction.
Last updated Sources: Health Canada product monograph
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 a corticosteroid with an NSAID increases the risk of gastrointestinal ulceration and bleeding. Ketorolac is particularly ulcerogenic, so the risk is clinically relevant.
What this interaction means in plain words
Cortisone 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 GI mucosal injury: ketorolac depletes protective prostaglandins while corticosteroids impair mucosal healing and repair.
What to do
Avoid or limit ketorolac to a short course, and consider gastroprotection with a proton pump inhibitor. Monitor for dyspepsia, melena and anemia.
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
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 Cortisone with Ketorolac?
MediHelp rates the interaction as major. Cortisone 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 a corticosteroid with an NSAID increases the risk of gastrointestinal ulceration and bleeding. Ketorolac is particularly ulcerogenic, so the risk is clinically relevant.
How serious is the interaction between Cortisone 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 or limit ketorolac to a short course, and consider gastroprotection with a proton pump inhibitor. Monitor for dyspepsia, melena and anemia.
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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