Drug interactions
Fluvoxamine + Ketorolac intranasal
Severity: Major
Fluvoxamine 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
SSRIs impair platelet aggregation and NSAIDs such as ketorolac inhibit platelets and damage gastric mucosa. Together they substantially increase the risk of gastrointestinal and other bleeding.
What this interaction means in plain words
Fluvoxamine 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 platelet dysfunction from SSRI serotonin depletion and NSAID cyclooxygenase inhibition, with NSAID mucosal injury.
What to do
Avoid or keep ketorolac to the shortest course, and consider gastroprotection with a proton pump inhibitor in at-risk patients. Watch for signs of gastrointestinal 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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References
Other interactions of Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
Frequently asked questions
Can I take Fluvoxamine with Ketorolac intranasal?
MediHelp rates the interaction as major. Fluvoxamine 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. SSRIs impair platelet aggregation and NSAIDs such as ketorolac inhibit platelets and damage gastric mucosa. Together they substantially increase the risk of gastrointestinal and other bleeding.
How serious is the interaction between Fluvoxamine 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 or keep ketorolac to the shortest course, and consider gastroprotection with a proton pump inhibitor in at-risk patients. Watch for signs of gastrointestinal bleeding.
What other medicines interact with Fluvoxamine?
MediHelp also lists interactions of Fluvoxamine with, for example, Agomelatine, Alosetron, Fezolinetant. The full list is on the Fluvoxamine page.
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