Drug interactions
Ketorolac intranasal + Perindopril
Severity: Major
Ketorolac intranasal and Perindopril: major 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 that is systemically absorbed from the nasal route and can reduce perindopril's antihypertensive effect. Together they raise the risk of acute kidney injury and hyperkalemia, particularly with volume depletion or renal impairment.
What this interaction means in plain words
Ketorolac intranasal and Perindopril can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Inhibition of renal prostaglandin synthesis reduces afferent arteriolar dilation while ACE inhibition reduces efferent tone, lowering glomerular filtration.
What to do
Avoid in patients with renal impairment or volume depletion; otherwise limit ketorolac to the shortest course. Monitor blood pressure, serum creatinine and potassium.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Perindopril
- Aliskiren + Perindopril Contraindicated
- Perindopril + Protein a column Contraindicated
- Perindopril + Sacubitril / valsartan Contraindicated
- Perindopril + Sacubitril-valsartan Contraindicated
- Amifostine + Perindopril Major
- Amiloride + Perindopril Major
Frequently asked questions
Can I take Ketorolac intranasal with Perindopril?
MediHelp rates the interaction as major. Ketorolac intranasal and Perindopril can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ketorolac is a potent NSAID that is systemically absorbed from the nasal route and can reduce perindopril's antihypertensive effect. Together they raise the risk of acute kidney injury and hyperkalemia, particularly with volume depletion or renal impairment.
How serious is the interaction between Ketorolac intranasal and Perindopril?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid in patients with renal impairment or volume depletion; otherwise limit ketorolac to the shortest course. Monitor blood pressure, serum creatinine and potassium.
What other medicines interact with Perindopril?
MediHelp also lists interactions of Perindopril with, for example, Aliskiren, Protein a column, Sacubitril / valsartan. The full list is on the Perindopril page.
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