Ketorolac Heparin

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... 

Clinically important, potentially hazardous interactions with acenocoumarol, anagrelide, anticoagulants, bismuth, boswellia, calcium hydroxylapatite, capsicum, cholestyramine, desvenlafaxine, devil s claw, dexamethasone, dexibuprofen, dicumarol, etodolac, evening primrose, flunisolide, ginkgo biloba, ginseng, heparin, ibuprofen, indomethacin, ketoprofen, ketorolac, lumiracoxib, methotrexate, methylprednisolone, nilutamide, NSAIDs, phellodendron, prednisone, resveratrol, reteplase, rivaroxaban, sermorelin, sulfites, tirofiban, triamcinolone, urokinase, valdecoxib, valproic acid, verapamil, warfarin... 

The CSM in the UK and the UK manufacturers say that ketorolac is contraindicated with anticoagulants, including low-dose heparin. Con-... 

Spowart K, Greer lA McLaren M, Lloyd J, Bullingh RES, Forbes CD. Haemostatic effects of ketorolac wi and without concomitant heparin in normal volunteers. Thromb Hae-mosf(1988)60,382-6. 

Greer IA Gibson JL, Yoi A Johnst ie J, Walker ID. Effect of ketorolac and low-molec-ular-we t heparin individually and in con bination on haemostasis. Blood Coag Fibrinol (1999) 10,367-73. 

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