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
NSAIDs such as ketorolac reduce renal prostaglandin synthesis, which can blunt the antihypertensive effect of sacubitril/valsartan and impair kidney function, especially in older or volume-depleted patients. Potassium may also rise because of reduced renal potassium excretion alongside angiotensin receptor blockade. Ketorolac is itself a high-risk NSAID for renal injury.
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.
Why it happens
NSAID inhibition of vasodilatory renal prostaglandins combined with angiotensin receptor blockade reduces glomerular filtration and potassium excretion.
What to do
Avoid ketorolac where possible, or limit to a very short course with adequate hydration. Monitor blood pressure, serum creatinine and potassium.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ketorolac and Sacubitril / valsartan, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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. NSAIDs such as ketorolac reduce renal prostaglandin synthesis, which can blunt the antihypertensive effect of sacubitril/valsartan and impair kidney function, especially in older or volume-depleted patients. Potassium may also rise because of reduced renal potassium excretion alongside angiotensin receptor blockade. Ketorolac is itself a high-risk NSAID for renal injury.
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 ketorolac where possible, or limit to a very short course with adequate hydration. Monitor blood pressure, serum creatinine and potassium.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
