Drug interactions
Enoxaparin + Ketorolac intranasal
Severity: Major
Enoxaparin and Ketorolac intranasal: major interaction.
Last updated Sources: US FDA label
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
Ketorolac is absorbed systemically after intranasal use and potently inhibits platelet function. Its labeling contraindicates concurrent use with anticoagulants due to the risk of serious bleeding.
What this interaction means in plain words
Enoxaparin 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 hemostatic impairment from ketorolac's COX-mediated platelet inhibition and mucosal injury plus enoxaparin anticoagulation.
What to do
Avoid the combination and use a non-NSAID analgesic. If unavoidable, monitor closely for bleeding and hemoglobin.
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 Enoxaparin
- Defibrotide + Enoxaparin Contraindicated
- Enoxaparin + Ketorolac Contraindicated
- Enoxaparin + Mifepristone Contraindicated
- Abciximab + Enoxaparin Major
- Aceclofenac + Enoxaparin Major
- Acetylsalicylic acid + Enoxaparin Major
Frequently asked questions
Can I take Enoxaparin with Ketorolac intranasal?
MediHelp rates the interaction as major. Enoxaparin 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. Ketorolac is absorbed systemically after intranasal use and potently inhibits platelet function. Its labeling contraindicates concurrent use with anticoagulants due to the risk of serious bleeding.
How serious is the interaction between Enoxaparin 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 the combination and use a non-NSAID analgesic. If unavoidable, monitor closely for bleeding and hemoglobin.
What other medicines interact with Enoxaparin?
MediHelp also lists interactions of Enoxaparin with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Enoxaparin page.
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