Drug interactions
Ketorolac + Telmisartan
Severity: Major
Ketorolac and Telmisartan: 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 reduce the antihypertensive effect of telmisartan and increase the risk of acute kidney injury and hyperkalemia. The risk is greatest in elderly, volume-depleted or renally impaired patients.
What this interaction means in plain words
Ketorolac and Telmisartan 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; Telmisartan belongs to Cardiovascular.
Why it happens
NSAID inhibition of renal prostaglandins constricts the afferent arteriole while the ARB dilates the efferent arteriole, reducing glomerular filtration and potassium excretion.
What to do
Avoid in volume-depleted or renally impaired patients; otherwise keep ketorolac brief, ensure hydration, and monitor blood pressure, 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?
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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 Telmisartan
- Aliskiren + Telmisartan Contraindicated
- Sparsentan + Telmisartan Contraindicated
- Amifostine + Telmisartan Major
- Amiloride + Telmisartan Major
- Amlodipine-benazepril + Telmisartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Telmisartan Major
Frequently asked questions
Can I take Ketorolac with Telmisartan?
MediHelp rates the interaction as major. Ketorolac and Telmisartan 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 reduce the antihypertensive effect of telmisartan and increase the risk of acute kidney injury and hyperkalemia. The risk is greatest in elderly, volume-depleted or renally impaired patients.
How serious is the interaction between Ketorolac and Telmisartan?
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 in volume-depleted or renally impaired patients; otherwise keep ketorolac brief, ensure hydration, and monitor blood pressure, 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.
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