Drug interactions
Ketorolac intranasal + Sacubitril-valsartan
Severity: Major
Ketorolac intranasal and Sacubitril-valsartan: 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, even intranasally, is absorbed systemically and, like other NSAIDs, can reduce renal prostaglandins, causing renal function deterioration, potassium retention and a weaker antihypertensive effect. Risk is greatest in elderly, dehydrated or renally impaired patients.
What this interaction means in plain words
Ketorolac intranasal and Sacubitril-valsartan 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
NSAID inhibition of prostaglandin-mediated renal vasodilation combined with angiotensin receptor blockade reduces glomerular filtration and potassium excretion.
What to do
Avoid the combination in patients with volume depletion or reduced renal function. If used briefly, ensure hydration and monitor creatinine, potassium and blood pressure.
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 Sacubitril-valsartan
- Aliskiren + Sacubitril-valsartan Contraindicated
- Benazepril + Sacubitril-valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Fosinopril + Sacubitril-valsartan Contraindicated
- Lisinopril + Sacubitril-valsartan Contraindicated
Frequently asked questions
Can I take Ketorolac intranasal with Sacubitril-valsartan?
MediHelp rates the interaction as major. Ketorolac intranasal and Sacubitril-valsartan 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, even intranasally, is absorbed systemically and, like other NSAIDs, can reduce renal prostaglandins, causing renal function deterioration, potassium retention and a weaker antihypertensive effect. Risk is greatest in elderly, dehydrated or renally impaired patients.
How serious is the interaction between Ketorolac intranasal and Sacubitril-valsartan?
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 the combination in patients with volume depletion or reduced renal function. If used briefly, ensure hydration and monitor creatinine, potassium and blood pressure.
What other medicines interact with Sacubitril-valsartan?
MediHelp also lists interactions of Sacubitril-valsartan with, for example, Aliskiren, Benazepril, Captopril. The full list is on the Sacubitril-valsartan page.
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