Patient Regimen

KETOROLAC TROMETHAMINE ORAL
IBUPROFEN ORAL

Interactions

Contraindicated Drug Combination
KETOROLAC/NSAID;ASPIRIN
Ketorolac Tromethamine Oral and Ibuprofen Oral may interact based on the potential interaction between KETOROLAC and NSAID;ASPIRIN.

Ketorolac/NSAID;Aspirin

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

MONOGRAPH TITLE: Ketorolac/NSAID;Aspirin

SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.

MECHANISM OF ACTION: Possible additive or synergistic side effects.(1)

CLINICAL EFFECTS: Concurrent use of ketorolac and other non-steroidal antiinflammatory agents (NSAIDs) or aspirin may result in an increase in NSAID-related side effects.(1)

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: The manufacturer of ketorolac states that concurrent use of ketorolac with either other NSAIDs or aspirin is contraindicated.(1)

DISCUSSION: There is no clinical documentation to support this interaction. The manufacturer of ketorolac states that as a result of the cumulative risks of inducing serious NSAID-related adverse events, the concurrent administration of ketorolac with other NSAIDs or aspirin is contraindicated.(1)

REFERENCES:

1.Toradol (ketorolac tromethamine) US prescribing information. Roche Pharmaceuticals January, 2007.
So, Good enough

I can hardly write english, but I can understand quite well medical information.
I like your blog a lot.

I’m not sure “accurate” is a useful term here. I tried an set of variables to compare what each tool would do with them and faithfully reported the results along with my comments and preferences.

I’m going to operate on the assumption that what you mean to say is that any comparison of such tools should include mention of what data each tool uses to look for interactions. This would be a fair point…if each of these sites made such information clear.

I think we generally agree and you noticed, I’m sure, that the post notes where the responses are clear and where they are confusing.

Where we differ is that I think something that is (as you say) “black and white” is exactly what is called for.

Pilgrim-

Yeah, that surprised me too!

Great post. I felt pretty confident of the drug checker we use, Drug Digest http://www.drugdigest.org/DD/Home
from Express Scripts. We link to it from the healthfinder.gov homepage. Confident that is until I checked the drugs in your example and the results show no interaction or warning. Thanks for the example.

Something that says “Do not take these two drugs together” seems to black and white. Maybe something along the lines of “Do not take these two drugs together unless you are being closely monitored by …”. And while I’m at it, wouldn’t it just be nice if consumer health resources used plain language when it suffices (e.g. what does contraindicated mean to your average person?).

No, I did not consider comparing these to professional tools built for healthcare professionals (like Lexi-Interact or MicroMedex).

I think it is almost always a bad idea to attempt to compare tools built for healthcare professionals and tools built for healthcare consumers.

The information as written for professionals is usually for use in a clinical setting where, as the monograph from Lexi-Interact states, the advisement to “Monitor therapy” can be followed. Renal failure, for instance, is somewhat dificult to monitor at home.

A healthcare consumer lacks the resources to respond appropriately should an interaction appear. For instance, it may be difficult to monitor for renal failure at home.

A healthcare consumer also usually lacks the education to judge from the information provided by a tool like Lexi-Interact how much danger this interaction may represent. I have (I think and hope) a greater level of health information literacy than the average healthcare consumer- but I wouldn’t know what to make of the Lexi-Interact information if I accessed it for free from home.

A healthcare consumer using an interaction checker from home needs, I believe, simpler information along the lines of: “Am I potentially putting myself in danger if I take these drugs together?” or “Is this something I need to discuss with my doctor?”

Jeff wrote:

So maybe not things you want to take together, but also maybe not the worst choice you could make, as some of the examples above suggest.

As to the degree of danger posed by the potential interaction between these two drugs, I defer to the expertise (and Doctorate in Pharmacy) of the PharmDs over my reading of a response from this one tool.

I’m an unusually well-informed healthcare consumer with access to professional health information tools and the skills to use them- but I don’t fool myself for a second into thinking that this makes me the equal of a physician or a pharmacist.

This long comment perhaps indicates I should write a post on the topic…?

Thanks for the comment, Jeff!

-David