Drug interactions
Ketorolac + Lithium
Severity: Major
Ketorolac and Lithium: 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
Ketorolac can raise serum lithium concentrations and lead to lithium toxicity with tremor, confusion, ataxia, and gastrointestinal symptoms. Ketorolac may also impair renal function, compounding the effect.
What this interaction means in plain words
Ketorolac and Lithium 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 belongs to Musculoskeletal; Lithium belongs to Central Nervous System.
Why it happens
NSAID inhibition of renal prostaglandins reduces renal blood flow and lithium clearance.
What to do
Avoid the combination if possible and prefer paracetamol. If it is used, monitor serum lithium and renal function closely and reduce the lithium dose as needed.
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
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Ketorolac with Lithium?
MediHelp rates the interaction as major. Ketorolac and Lithium 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 can raise serum lithium concentrations and lead to lithium toxicity with tremor, confusion, ataxia, and gastrointestinal symptoms. Ketorolac may also impair renal function, compounding the effect.
How serious is the interaction between Ketorolac and Lithium?
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 if possible and prefer paracetamol. If it is used, monitor serum lithium and renal function closely and reduce the lithium dose as needed.
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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