Drug interactions
Ketorolac + Tobramycin
Severity: Moderate
Ketorolac and Tobramycin: 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
Ketorolac may impair renal function and decrease tobramycin clearance, raising aminoglycoside concentrations, with additive nephrotoxicity. Risk is highest in neonates, older patients and those who are dehydrated.
What this interaction means in plain words
Ketorolac and Tobramycin 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.
Ketorolac belongs to Musculoskeletal; Tobramycin belongs to Anti Bacterial.
Why it happens
NSAID inhibition of renal prostaglandins reduces glomerular filtration and aminoglycoside clearance, with additive renal toxicity.
What to do
Monitor serum creatinine and tobramycin trough levels and adjust dosing. Prefer a non-NSAID analgesic in patients with renal risk factors.
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
Other interactions of Tobramycin
- Cidofovir + Tobramycin Contraindicated
- Adefovir + Tobramycin Major
- Amikacin + Tobramycin Major
- Amphotericin b deoxycholate + Tobramycin Major
- Amphotericin b + Tobramycin Major
- Atracurium + Tobramycin Major
Frequently asked questions
Can I take Ketorolac with Tobramycin?
MediHelp rates the interaction as moderate. Ketorolac and Tobramycin 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. Ketorolac may impair renal function and decrease tobramycin clearance, raising aminoglycoside concentrations, with additive nephrotoxicity. Risk is highest in neonates, older patients and those who are dehydrated.
How serious is the interaction between Ketorolac and Tobramycin?
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 tobramycin trough levels and adjust dosing. Prefer a non-NSAID analgesic in patients with renal risk factors.
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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