Enoxaparin NSAIDs

HEPARINS ANALESICS - NSAIDs 1. Risk of prolonged bleeding when ketorolac is co-administered with dalteparin (but not enoxaparin), and intravenous diclofenac is given with heparins 2. t risk of hyperkalaemia when ketorolac is given with heparin 1. Uncertain 2. Heparin inhibits aldosterone secretion, causing hyperkalaemia 1. Avoid co-administration 2. Monitor potassium levels closely... 

The use of enoxaparin, ketorolac, and aspirin were considered to be contributing factors in a case of spinal haematoma occurring after lumbar puncture, which resulted in paraplegia. Another case has also been briefly described. In an analysis of reports from the FDA in the US, 16 of 43 patients who developed spinal or epidural haematoma after receiving enoxaparin had received concurrent drugs known to prolong bleeding, such as ketorolac or other NSAIDs. ... 

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