Drug interactions
Ketorolac + Pegaspargase
Severity: Major
Ketorolac and Pegaspargase: 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
Pegaspargase can cause coagulation abnormalities such as reduced fibrinogen and other clotting factors, as well as thrombocytopenia. Ketorolac adds platelet inhibition and gastrointestinal bleeding risk, so serious bleeding is more likely.
What this interaction means in plain words
Ketorolac and Pegaspargase 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; Pegaspargase belongs to Oncology.
Why it happens
Pegaspargase-induced coagulopathy and thrombocytopenia combined with ketorolac antiplatelet effect and mucosal injury.
What to do
Avoid ketorolac during pegaspargase treatment where possible and use an alternative analgesic. If used, monitor coagulation tests, platelet count and signs of 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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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 Pegaspargase
- Etodolac + Pegaspargase Major
- Mefenamic acid + Pegaspargase Major
- Acetylsalicylic acid + Pegaspargase Moderate
- Argatroban + Pegaspargase Moderate
- Celecoxib + Pegaspargase Moderate
- Dabigatran etexilate + Pegaspargase Moderate
Frequently asked questions
Can I take Ketorolac with Pegaspargase?
MediHelp rates the interaction as major. Ketorolac and Pegaspargase 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. Pegaspargase can cause coagulation abnormalities such as reduced fibrinogen and other clotting factors, as well as thrombocytopenia. Ketorolac adds platelet inhibition and gastrointestinal bleeding risk, so serious bleeding is more likely.
How serious is the interaction between Ketorolac and Pegaspargase?
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 ketorolac during pegaspargase treatment where possible and use an alternative analgesic. If used, monitor coagulation tests, platelet count and signs of bleeding.
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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