Drug interactions
Ketorolac intranasal + Tobramycin
Severity: Moderate
Ketorolac intranasal and Tobramycin: 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 renal effects, and even with intranasal use there is systemic absorption. It may reduce renal perfusion and add nephrotoxic risk to tobramycin, with higher aminoglycoside levels reported mainly in neonates.
What this interaction means in plain words
Ketorolac intranasal and Tobramycin 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
Prostaglandin inhibition reduces renal blood flow and glomerular filtration, lowering tobramycin clearance.
What to do
Monitor serum creatinine and tobramycin troughs, especially with dehydration or renal impairment. Limit ketorolac duration or choose another analgesic.
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 Tobramycin
- Cidofovir + Tobramycin Contraindicated
- Adefovir + Tobramycin Major
- Amikacin + Tobramycin Major
- Amphotericin b deoxycholate + Tobramycin Major
- Amphotericin b + Tobramycin Major
- Atracurium + Tobramycin Major
Frequently asked questions
Can I take Ketorolac intranasal with Tobramycin?
MediHelp rates the interaction as moderate. Ketorolac intranasal and Tobramycin 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 renal effects, and even with intranasal use there is systemic absorption. It may reduce renal perfusion and add nephrotoxic risk to tobramycin, with higher aminoglycoside levels reported mainly in neonates.
How serious is the interaction between Ketorolac intranasal and Tobramycin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum creatinine and tobramycin troughs, especially with dehydration or renal impairment. Limit ketorolac duration or choose another analgesic.
What other medicines interact with Tobramycin?
MediHelp also lists interactions of Tobramycin with, for example, Cidofovir, Adefovir, Amikacin. The full list is on the Tobramycin page.
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