Ketorolac and Ibuprofen: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ibuprofen
Ketorolac
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.
What happens
Enhanced gastrointestinal adverse effects (peptic ulcers, gastrointestinal bleeding and/or perforation)
Interaction Deep Dive
Ketorolac oral or IV is contraindicated in patients currently receiving aspirin or NSAIDs because of the cumulative risks of inducing serious NSAID-related adverse events (peptic ulcers, gastrointestinal (GI) bleeding and/or perforation)31. Concomitant use of the nasal spray with other NSAIDs is not recommended due an increased risk for GI toxicity with little or no improvement in efficacy 2.
Why it happens (mechanism)
Additive gastrointestinal irritation
Common questions
Can I take Ketorolac and Ibuprofen together?
Enhanced gastrointestinal adverse effects (peptic ulcers, gastrointestinal bleeding and/or perforation) Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ketorolac and Ibuprofen interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Ketorolac or Ibuprofen 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 (3)
- Product Information: ketorolac tromethamine IV, IM injection, ketorolac tromethamine IV, IM injection. Bedford Laboratories (TM), Bedford, OH, 2009.
- Product Information: SPRIX(R) nasal spray, ketorolac tromethamine nasal spray. Egalet US Inc. (per FDA), Wayne, PA, 2016. DailyMed
- Product Information: ketorolac tromethamine oral film coated tablets, ketorolac tromethamine oral film coated tablets. Teva Pharmaceuticals USA (per Dailymed), Sellersville, PA, 2009. DailyMed
Keep reading about Ibuprofen
Keep reading about Ketorolac
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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