Drug interactions
Ketorolac + Warfarin
Severity: Contraindicated
Ketorolac and Warfarin: 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 inhibits platelet function and can cause gastrointestinal ulceration, so combined with warfarin it markedly increases the risk of serious bleeding. Ketorolac is contraindicated in patients at high bleeding risk and with anticoagulants per labeling.
What this interaction means in plain words
Ketorolac and Warfarin 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; Warfarin belongs to Cardiovascular.
Why it happens
Additive impairment of hemostasis: ketorolac inhibits platelet aggregation and damages gastric mucosa while warfarin reduces clotting factor synthesis.
What to do
Avoid ketorolac in patients on warfarin and use a non-NSAID analgesic such as paracetamol. If an NSAID is unavoidable, monitor INR and watch for bleeding with gastroprotection.
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 Warfarin
- Defibrotide + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
- Amobarbital + Warfarin Major
Frequently asked questions
Can I take Ketorolac with Warfarin?
MediHelp rates the interaction as contraindicated. Ketorolac and Warfarin 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 inhibits platelet function and can cause gastrointestinal ulceration, so combined with warfarin it markedly increases the risk of serious bleeding. Ketorolac is contraindicated in patients at high bleeding risk and with anticoagulants per labeling.
How serious is the interaction between Ketorolac and Warfarin?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid ketorolac in patients on warfarin and use a non-NSAID analgesic such as paracetamol. If an NSAID is unavoidable, monitor INR and watch for bleeding with gastroprotection.
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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