Drug Interaction Report

Aspirin Rectal and Ketorolac: Interaction Details

A pharmacist-reviewed analysis of the Aspirin Rectal and Ketorolac interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Aspirin Rectal

Aspirin
+

Ketorolac

Acular Acuvail Sprix Toradol®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Jul 11, 2026
Editorial policy · Data sources
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Interaction severity
Contraindicated
These should generally not be used together.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 385 documented Aspirin Rectal interactions, 6 are rated contraindicated — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Contraindicated

What happens

Enhanced gastrointestinal adverse effects (peptic ulcers, gastrointestinal bleeding, and/or perforation) and possible increase in serum ketorolac levels

Interaction Deep Dive

Oral ketorolac is contraindicated in patients currently receiving aspirin or NSAIDs because of the cumulative risks of inducing serious NSAID-related adverse events (peptic ulcers, gastrointestinal bleeding, and/or perforation). In addition, free ketorolac plasma levels may increase during concomitant administration with salicylates. At therapeutic concentrations of salicylate (300 mcg/mL), the binding of ketorolac was reduced from approximately 99.2% to 97.5%, representing a potential 2-fold increase in unbound ketorolac plasma levels2. The concomitant use of ketorolac nasal spray and aspirin is also generally not recommended 1.

Why it happens (mechanism)

Additive gastrointestinal irritation and reduced ketorolac plasma protein binding

Common questions

Can I take Aspirin Rectal and Ketorolac together?

Enhanced gastrointestinal adverse effects (peptic ulcers, gastrointestinal bleeding, and/or perforation) and possible increase in serum ketorolac levels Always confirm with your pharmacist or prescriber before making any change.

How serious is the Aspirin Rectal and Ketorolac interaction?

It is rated contraindicated. These should generally not be used together.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Aspirin Rectal or Ketorolac need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (2)

  1. Product Information: SPRIX(TM) nasal spray, ketorolac tromethamine nasal spray. Roxro Pharma, Inc, Menlo Park, CA, 2009. DailyMed
  2. Product Information: TORADOL(R) oral tablets, ketorolac tromethamine oral tablets. Roche Pharmaceuticals,Inc, Nutley, NJ, 2007. DailyMed
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Aspirin Rectal

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.