Drug interactions
Ketorolac + Rivaroxaban
Severity: Contraindicated
Ketorolac and Rivaroxaban: contraindicated 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 combined with rivaroxaban substantially increases the risk of serious bleeding, including gastrointestinal hemorrhage. Ketorolac is itself labeled as contraindicated in patients at risk of bleeding and with concurrent anticoagulants.
What this interaction means in plain words
Ketorolac and Rivaroxaban are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Ketorolac belongs to Musculoskeletal; Rivaroxaban belongs to Cardiovascular.
Why it happens
Additive hemostatic impairment from factor Xa inhibition and NSAID-mediated platelet dysfunction, plus NSAID gastrointestinal mucosal injury.
What to do
Avoid ketorolac in patients taking rivaroxaban and use a non-NSAID analgesic such as paracetamol instead. If bleeding is suspected, check hemoglobin and manage promptly.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban Major
- Alteplase + Rivaroxaban Major
Frequently asked questions
Can I take Ketorolac with Rivaroxaban?
MediHelp rates the interaction as contraindicated. Ketorolac and Rivaroxaban are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ketorolac combined with rivaroxaban substantially increases the risk of serious bleeding, including gastrointestinal hemorrhage. Ketorolac is itself labeled as contraindicated in patients at risk of bleeding and with concurrent anticoagulants.
How serious is the interaction between Ketorolac and Rivaroxaban?
MediHelp rates it contraindicated, 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 rivaroxaban and use a non-NSAID analgesic such as paracetamol instead. If bleeding is suspected, check hemoglobin and manage promptly.
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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