Drug interactions
Dabigatran + Ketorolac
Severity: Major
Dabigatran 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 increase bleeding risk, and ketorolac may also cause gastrointestinal ulceration and impair renal function, which can raise dabigatran exposure. Ketorolac labeling prohibits use in patients receiving anticoagulants.
What this interaction means in plain words
Dabigatran 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 pharmacodynamic bleeding risk from direct thrombin inhibition plus platelet inhibition and mucosal injury, with possible renal impairment reducing dabigatran clearance.
What to do
Avoid ketorolac in patients on dabigatran and use a non-NSAID analgesic such as paracetamol. If unavoidable, give the shortest course and monitor for bleeding and renal function.
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
Frequently asked questions
Can I take Dabigatran with Ketorolac?
MediHelp rates the interaction as major. Dabigatran 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 increase bleeding risk, and ketorolac may also cause gastrointestinal ulceration and impair renal function, which can raise dabigatran exposure. Ketorolac labeling prohibits use in patients receiving anticoagulants.
How serious is the interaction between Dabigatran 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 on dabigatran and use a non-NSAID analgesic such as paracetamol. If unavoidable, give the shortest course and monitor for bleeding and renal function.
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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