Drug interactions
Ketorolac + Paroxetine
Severity: Major
Ketorolac and Paroxetine: 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
Combining an SSRI with ketorolac raises the risk of bleeding, especially from the upper gastrointestinal tract. Ketorolac is a potent NSAID that damages the gastric mucosa and impairs platelet function, and SSRIs add to the platelet effect.
What this interaction means in plain words
Ketorolac and Paroxetine 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; Paroxetine belongs to Central Nervous System.
Why it happens
Additive impairment of platelet aggregation (SSRI depletion of platelet serotonin plus NSAID cyclooxygenase inhibition) together with NSAID-induced mucosal injury.
What to do
Avoid prolonged co-use and keep ketorolac courses as short as possible; consider gastroprotection with a proton pump inhibitor and monitor for melena, hematemesis or falling 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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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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Ketorolac with Paroxetine?
MediHelp rates the interaction as major. Ketorolac and Paroxetine 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. Combining an SSRI with ketorolac raises the risk of bleeding, especially from the upper gastrointestinal tract. Ketorolac is a potent NSAID that damages the gastric mucosa and impairs platelet function, and SSRIs add to the platelet effect.
How serious is the interaction between Ketorolac and Paroxetine?
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 prolonged co-use and keep ketorolac courses as short as possible; consider gastroprotection with a proton pump inhibitor and monitor for melena, hematemesis or falling hemoglobin.
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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