Drug interactions
Ketorolac + Tobramycin inhaled
Severity: Moderate
Ketorolac and Tobramycin inhaled: moderate 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
Inhaled tobramycin has low systemic absorption in most patients, but some reaches the circulation and can accumulate with renal impairment. Ketorolac may reduce renal function and so add nephrotoxic and ototoxic risk, mainly with prolonged or repeated use.
What this interaction means in plain words
Ketorolac and Tobramycin inhaled can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive nephrotoxicity from NSAID-related renal hemodynamic effects and aminoglycoside tubular toxicity, which can raise systemic aminoglycoside levels.
What to do
Monitor serum creatinine and hydration status, and avoid prolonged ketorolac courses in patients on inhaled tobramycin. Check tobramycin serum levels if renal function declines.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Tobramycin inhaled?
MediHelp rates the interaction as moderate. Ketorolac and Tobramycin inhaled can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Inhaled tobramycin has low systemic absorption in most patients, but some reaches the circulation and can accumulate with renal impairment. Ketorolac may reduce renal function and so add nephrotoxic and ototoxic risk, mainly with prolonged or repeated use.
How serious is the interaction between Ketorolac and Tobramycin inhaled?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum creatinine and hydration status, and avoid prolonged ketorolac courses in patients on inhaled tobramycin. Check tobramycin serum levels if renal function declines.
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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