Drug interactions
Ketorolac + Spironolactone
Severity: Major
Ketorolac and Spironolactone: 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 can blunt the natriuretic and antihypertensive effects of spironolactone and reduces renal potassium excretion. Together they raise the risk of hyperkalemia and acute kidney injury, especially in patients with renal impairment, diabetes or heart failure.
What this interaction means in plain words
Ketorolac and Spironolactone 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; Spironolactone belongs to Cardiovascular.
Why it happens
NSAID inhibition of renal prostaglandins reduces renal blood flow, aldosterone-related potassium excretion and renin release, adding to the potassium-retaining effect of spironolactone.
What to do
Avoid prolonged use together; if ketorolac is needed, keep the course short and check serum potassium and creatinine within the first days. Consider an alternative analgesic in patients with renal impairment.
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 Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
Frequently asked questions
Can I take Ketorolac with Spironolactone?
MediHelp rates the interaction as major. Ketorolac and Spironolactone 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 can blunt the natriuretic and antihypertensive effects of spironolactone and reduces renal potassium excretion. Together they raise the risk of hyperkalemia and acute kidney injury, especially in patients with renal impairment, diabetes or heart failure.
How serious is the interaction between Ketorolac and Spironolactone?
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 prolonged use together; if ketorolac is needed, keep the course short and check serum potassium and creatinine within the first days. Consider an alternative analgesic in patients with renal impairment.
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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