Drug interactions
Ketorolac + Prasugrel
Severity: Major
Ketorolac and Prasugrel: 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 inhibits platelet function and can injure the gastric mucosa, and prasugrel is a potent P2Y12 antiplatelet agent. Together they raise the risk of serious gastrointestinal and other bleeding. Ketorolac labeling already contraindicates its use in patients at risk of bleeding and with antiplatelet agents.
What this interaction means in plain words
Ketorolac and Prasugrel 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; Prasugrel belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic antiplatelet effect (COX-1 inhibition plus P2Y12 blockade) with NSAID-related mucosal injury.
What to do
Avoid ketorolac in patients taking prasugrel and choose a non-NSAID analgesic such as paracetamol. If an NSAID is unavoidable, keep it brief and monitor for bleeding and consider gastroprotection.
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 Prasugrel
Frequently asked questions
Can I take Ketorolac with Prasugrel?
MediHelp rates the interaction as major. Ketorolac and Prasugrel 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 inhibits platelet function and can injure the gastric mucosa, and prasugrel is a potent P2Y12 antiplatelet agent. Together they raise the risk of serious gastrointestinal and other bleeding. Ketorolac labeling already contraindicates its use in patients at risk of bleeding and with antiplatelet agents.
How serious is the interaction between Ketorolac and Prasugrel?
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 taking prasugrel and choose a non-NSAID analgesic such as paracetamol. If an NSAID is unavoidable, keep it brief and monitor for bleeding and consider gastroprotection.
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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