Drug interactions
Ketorolac + Ticagrelor
Severity: Major
Ketorolac and Ticagrelor: 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
Combining ketorolac with ticagrelor increases bleeding risk, including gastrointestinal hemorrhage. Ketorolac is labeled as contraindicated in patients at risk of bleeding and with agents that affect hemostasis.
What this interaction means in plain words
Ketorolac and Ticagrelor 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; Ticagrelor belongs to Cardiovascular.
Why it happens
Additive platelet inhibition (P2Y12 blockade plus COX-1 inhibition) together with NSAID gastric mucosal injury.
What to do
Avoid ketorolac and use paracetamol or another non-NSAID analgesic; if unavoidable, give a proton pump inhibitor and monitor for bleeding and hemoglobin drop.
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 Ticagrelor
- Itraconazole + Ticagrelor Contraindicated
- Ketoconazole + Ticagrelor Contraindicated
- Levoketoconazole + Ticagrelor Contraindicated
- Abciximab + Ticagrelor Major
- Abrocitinib + Ticagrelor Major
- Acalabrutinib + Ticagrelor Major
Frequently asked questions
Can I take Ketorolac with Ticagrelor?
MediHelp rates the interaction as major. Ketorolac and Ticagrelor 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. Combining ketorolac with ticagrelor increases bleeding risk, including gastrointestinal hemorrhage. Ketorolac is labeled as contraindicated in patients at risk of bleeding and with agents that affect hemostasis.
How serious is the interaction between Ketorolac and Ticagrelor?
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 and use paracetamol or another non-NSAID analgesic; if unavoidable, give a proton pump inhibitor and monitor for bleeding and hemoglobin drop.
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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