Drug interactions
Ketorolac + Pemetrexed
Severity: Major
Ketorolac and Pemetrexed: 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
NSAIDs can raise pemetrexed exposure in patients with reduced kidney function, increasing the risk of myelosuppression, mucositis and renal and gastrointestinal toxicity. Ketorolac is a potent nephrotoxic NSAID, which makes this more concerning.
What this interaction means in plain words
Ketorolac and Pemetrexed 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; Pemetrexed belongs to Oncology.
Why it happens
NSAID-related reduction in renal function and competition for tubular secretion decrease pemetrexed clearance.
What to do
Avoid ketorolac around pemetrexed dosing and use an alternative analgesic. If an NSAID is unavoidable, monitor blood counts and renal function closely and follow labeled NSAID interruption windows based on half-life.
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 Pemetrexed
Frequently asked questions
Can I take Ketorolac with Pemetrexed?
MediHelp rates the interaction as major. Ketorolac and Pemetrexed 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. NSAIDs can raise pemetrexed exposure in patients with reduced kidney function, increasing the risk of myelosuppression, mucositis and renal and gastrointestinal toxicity. Ketorolac is a potent nephrotoxic NSAID, which makes this more concerning.
How serious is the interaction between Ketorolac and Pemetrexed?
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 around pemetrexed dosing and use an alternative analgesic. If an NSAID is unavoidable, monitor blood counts and renal function closely and follow labeled NSAID interruption windows based on half-life.
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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