Drug interactions
Ketorolac intranasal + Milnacipran
Severity: Moderate
Ketorolac intranasal and Milnacipran: 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 is a potent NSAID with significant systemic absorption from nasal use, causing platelet inhibition and GI mucosal injury. With milnacipran, the bleeding risk rises, especially in the upper GI tract.
What this interaction means in plain words
Ketorolac intranasal and Milnacipran 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 platelet dysfunction (SNRI serotonin depletion plus NSAID COX inhibition) with NSAID mucosal injury.
What to do
Limit ketorolac to the shortest course and monitor for bleeding. Consider gastroprotection and avoid other bleeding-risk drugs.
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 Milnacipran
- Isocarboxazid + Milnacipran Contraindicated
- Methylene blue + Milnacipran Contraindicated
- Milnacipran + Phenelzine Contraindicated
- Milnacipran + Procarbazine Contraindicated
- Milnacipran + Rasagiline Contraindicated
- Milnacipran + Safinamide Contraindicated
Frequently asked questions
Can I take Ketorolac intranasal with Milnacipran?
MediHelp rates the interaction as moderate. Ketorolac intranasal and Milnacipran 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 is a potent NSAID with significant systemic absorption from nasal use, causing platelet inhibition and GI mucosal injury. With milnacipran, the bleeding risk rises, especially in the upper GI tract.
How serious is the interaction between Ketorolac intranasal and Milnacipran?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit ketorolac to the shortest course and monitor for bleeding. Consider gastroprotection and avoid other bleeding-risk drugs.
What other medicines interact with Milnacipran?
MediHelp also lists interactions of Milnacipran with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Milnacipran page.
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