Drug interactions
Ketorolac + Sacubitril-valsartan
Severity: Major
Ketorolac and Sacubitril-valsartan: 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 is a potent NSAID that reduces renal prostaglandin synthesis and can precipitate acute kidney injury in patients taking sacubitril-valsartan, especially if volume depleted or elderly. It may also blunt the antihypertensive effect and raise potassium.
What this interaction means in plain words
Ketorolac and Sacubitril-valsartan 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; Sacubitril-valsartan belongs to Cardiovascular.
Why it happens
NSAID inhibition of vasodilatory renal prostaglandins combined with angiotensin receptor blockade reduces glomerular filtration and potassium excretion.
What to do
Avoid the combination where possible and use a non-NSAID analgesic. If ketorolac is given, keep the course short and monitor creatinine, potassium and hydration.
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 Sacubitril-valsartan
- Aliskiren + Sacubitril-valsartan Contraindicated
- Benazepril + Sacubitril-valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Fosinopril + Sacubitril-valsartan Contraindicated
- Lisinopril + Sacubitril-valsartan Contraindicated
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 Sacubitril-valsartan?
MediHelp rates the interaction as major. Ketorolac and Sacubitril-valsartan 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 is a potent NSAID that reduces renal prostaglandin synthesis and can precipitate acute kidney injury in patients taking sacubitril-valsartan, especially if volume depleted or elderly. It may also blunt the antihypertensive effect and raise potassium.
How serious is the interaction between Ketorolac and Sacubitril-valsartan?
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 the combination where possible and use a non-NSAID analgesic. If ketorolac is given, keep the course short and monitor creatinine, potassium and hydration.
What other medicines interact with Sacubitril-valsartan?
MediHelp also lists interactions of Sacubitril-valsartan with, for example, Aliskiren, Benazepril, Captopril. The full list is on the Sacubitril-valsartan page.
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