Drug interactions
Ibuprofen + Ketorolac
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.
Overview
Concomitant use is contraindicated due to markedly increased risk of serious gastrointestinal bleeding/ulceration, renal toxicity, and additive antiplatelet effects.
Mechanism of action
Additive pharmacodynamic inhibition of prostaglandin synthesis via COX-1/COX-2, reducing gastric mucosal protection, impairing renal perfusion, and decreasing platelet aggregation; no clinically meaningful pharmacokinetic interaction.
Clinical management
Do not coadminister. Discontinue one NSAID and use a non-NSAID analgesic (e.g., acetaminophen) if additional pain control is needed. If inadvertent co-use occurs, stop one agent and evaluate for GI bleeding and renal dysfunction.
Drug reference
References
- Toradol (ketorolac tromethamine) Prescribing Information — FDA Label
- Ketorolac: Drug Information — UpToDate
- Drug Interactions: Ketorolac and Ibuprofen — Lexicomp
Frequently asked questions
Can I take Ibuprofen with Ketorolac?
The interaction is rated: Contraindicated. Concomitant use is contraindicated due to markedly increased risk of serious gastrointestinal bleeding/ulceration, renal toxicity, and additive antiplatelet effects.
How serious is the interaction between Ibuprofen and Ketorolac?
The interaction is rated: Contraindicated. Evidence level: High.
How is the interaction between Ibuprofen and Ketorolac managed?
Do not coadminister. Discontinue one NSAID and use a non-NSAID analgesic (e.g., acetaminophen) if additional pain control is needed. If inadvertent co-use occurs, stop one agent and evaluate for GI bleeding and renal dysfunction.
Why do Ibuprofen and Ketorolac interact?
Additive pharmacodynamic inhibition of prostaglandin synthesis via COX-1/COX-2, reducing gastric mucosal protection, impairing renal perfusion, and decreasing platelet aggregation; no clinically meaningful pharmacokinetic interaction.
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