Drug interactions
Ketorolac + Tolmetin
Severity: Contraindicated
Ketorolac and Tolmetin: contraindicated 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 is contraindicated with other NSAIDs because the combination adds to the risk of gastrointestinal bleeding and ulceration, renal injury and platelet inhibition without any added analgesic benefit. Tolmetin is a conventional NSAID, so the toxicities stack.
What this interaction means in plain words
Ketorolac and Tolmetin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Ketorolac belongs to Musculoskeletal; Tolmetin belongs to Musculoskeletal.
Why it happens
Additive pharmacodynamic effects from inhibition of cyclooxygenase and prostaglandin synthesis by two NSAIDs.
What to do
Do not co-administer; use a single NSAID at a time and stop tolmetin before starting ketorolac. If more analgesia is needed, add a non-NSAID such as paracetamol or an opioid.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin Major
- Apixaban + Tolmetin Major
Frequently asked questions
Can I take Ketorolac with Tolmetin?
MediHelp rates the interaction as contraindicated. Ketorolac and Tolmetin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ketorolac is contraindicated with other NSAIDs because the combination adds to the risk of gastrointestinal bleeding and ulceration, renal injury and platelet inhibition without any added analgesic benefit. Tolmetin is a conventional NSAID, so the toxicities stack.
How serious is the interaction between Ketorolac and Tolmetin?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer; use a single NSAID at a time and stop tolmetin before starting ketorolac. If more analgesia is needed, add a non-NSAID such as paracetamol or an opioid.
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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