Drug interactions
Fosinopril + Ketorolac intranasal
Severity: Major
Fosinopril 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 a potent NSAID that is systemically absorbed from the nasal route and can reduce fosinopril's antihypertensive effect. Together they raise the risk of acute kidney injury and hyperkalemia, particularly with volume depletion or renal impairment.
What this interaction means in plain words
Fosinopril 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
Inhibition of renal prostaglandin synthesis reduces afferent arteriolar dilation while ACE inhibition reduces efferent tone, lowering glomerular filtration.
What to do
Avoid in patients with renal impairment or volume depletion; otherwise limit ketorolac to the shortest course. Monitor blood pressure, serum creatinine and potassium.
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 Fosinopril
- Aliskiren + Fosinopril Contraindicated
- Fosinopril + Protein a column Contraindicated
- Fosinopril + Sacubitril / valsartan Contraindicated
- Fosinopril + Sacubitril-valsartan Contraindicated
- Amifostine + Fosinopril Major
- Amiloride + Fosinopril Major
Frequently asked questions
Can I take Fosinopril with Ketorolac intranasal?
MediHelp rates the interaction as major. Fosinopril 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 a potent NSAID that is systemically absorbed from the nasal route and can reduce fosinopril's antihypertensive effect. Together they raise the risk of acute kidney injury and hyperkalemia, particularly with volume depletion or renal impairment.
How serious is the interaction between Fosinopril 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 in patients with renal impairment or volume depletion; otherwise limit ketorolac to the shortest course. Monitor blood pressure, serum creatinine and potassium.
What other medicines interact with Fosinopril?
MediHelp also lists interactions of Fosinopril with, for example, Aliskiren, Protein a column, Sacubitril / valsartan. The full list is on the Fosinopril page.
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