Drug interactions
Ketorolac + Tolbutamide
Severity: Moderate
Ketorolac and Tolbutamide: 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
NSAIDs may enhance the glucose lowering effect of sulfonylureas, occasionally causing hypoglycemia. The effect is inconsistent but is more plausible with highly protein-bound sulfonylureas such as tolbutamide.
What this interaction means in plain words
Ketorolac and Tolbutamide 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; Tolbutamide belongs to Endocrine.
Why it happens
Possible displacement of tolbutamide from plasma protein binding and prostaglandin-related effects on insulin secretion; the mechanism is not firmly established.
What to do
Monitor blood glucose more frequently when ketorolac is started and reduce the tolbutamide dose if hypoglycemia occurs.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ketorolac and Tolbutamide, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
Frequently asked questions
Can I take Ketorolac with Tolbutamide?
MediHelp rates the interaction as moderate. Ketorolac and Tolbutamide 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. NSAIDs may enhance the glucose lowering effect of sulfonylureas, occasionally causing hypoglycemia. The effect is inconsistent but is more plausible with highly protein-bound sulfonylureas such as tolbutamide.
How serious is the interaction between Ketorolac and Tolbutamide?
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 blood glucose more frequently when ketorolac is started and reduce the tolbutamide dose if hypoglycemia occurs.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
