Drug interactions
Ketorolac + Tenofovir df
Severity: Major
Ketorolac and Tenofovir df: 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
Tenofovir is eliminated by glomerular filtration and active tubular secretion, and NSAIDs such as ketorolac can reduce renal perfusion and compete for tubular transport. Together they may raise tenofovir exposure and increase the risk of kidney injury, especially with high or repeated NSAID doses.
What this interaction means in plain words
Ketorolac and Tenofovir df 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
Additive nephrotoxicity through NSAID-induced reduction of renal prostaglandin-dependent blood flow and competition for renal tubular secretion.
What to do
Avoid ketorolac in patients taking tenofovir where possible and choose alternative analgesics such as paracetamol. If an NSAID is unavoidable, use the lowest dose for the shortest time and monitor serum creatinine and phosphate.
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
Frequently asked questions
Can I take Ketorolac with Tenofovir df?
MediHelp rates the interaction as major. Ketorolac and Tenofovir df 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. Tenofovir is eliminated by glomerular filtration and active tubular secretion, and NSAIDs such as ketorolac can reduce renal perfusion and compete for tubular transport. Together they may raise tenofovir exposure and increase the risk of kidney injury, especially with high or repeated NSAID doses.
How serious is the interaction between Ketorolac and Tenofovir df?
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 in patients taking tenofovir where possible and choose alternative analgesics such as paracetamol. If an NSAID is unavoidable, use the lowest dose for the shortest time and monitor serum creatinine and phosphate.
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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