Drug interactions
Ketorolac + Phenindione
Severity: Major
Ketorolac and Phenindione: 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
Phenindione is a vitamin K antagonist, and ketorolac inhibits platelet function and can cause GI ulceration. Together they markedly increase the risk of serious bleeding.
What this interaction means in plain words
Ketorolac and Phenindione 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.
Why it happens
Additive hemostatic impairment from anticoagulation and NSAID antiplatelet and mucosal effects.
What to do
Avoid ketorolac in patients on phenindione; use paracetamol or another non-NSAID analgesic and monitor INR and signs of bleeding if exposure occurs.
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
Frequently asked questions
Can I take Ketorolac with Phenindione?
MediHelp rates the interaction as major. Ketorolac and Phenindione 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. Phenindione is a vitamin K antagonist, and ketorolac inhibits platelet function and can cause GI ulceration. Together they markedly increase the risk of serious bleeding.
How serious is the interaction between Ketorolac and Phenindione?
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 in patients on phenindione; use paracetamol or another non-NSAID analgesic and monitor INR and signs of bleeding if exposure occurs.
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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