From the FDA Drug Label
Ketorolac tromethamine is contraindicated in patients currently receiving aspirin or NSAIDs because of the cumulative risks of inducing serious NSAID-related adverse events.
Administration of ketorolac after taking meloxicam is not recommended due to the increased risk of serious NSAID-related adverse events, as both ketorolac and meloxicam are NSAIDs. 1
From the Research
No, it is not safe to administer ketorolac after taking meloxicam due to the increased risk of serious side effects, including gastrointestinal bleeding, ulceration, and perforation, as well as cardiovascular events, kidney damage, and high blood pressure. These medications are both nonsteroidal anti-inflammatory drugs (NSAIDs) and should not be used together because they work through the same mechanism - inhibiting cyclooxygenase enzymes that produce inflammatory prostaglandins - which does not provide additional therapeutic benefit but substantially increases risks 2.
Key Considerations
- Taking multiple NSAIDs simultaneously significantly raises the risk of gastrointestinal complications, such as ulcers or bleeding, especially in patients with advanced age, history of peptic ulcer, Helicobacter pylori infection, or those using anticoagulants or antiplatelet agents 3.
- Combining NSAIDs increases the risk of cardiovascular events, kidney damage, and high blood pressure, making it crucial to consider individual patient risks when prescribing these medications 2.
- If additional pain relief is needed while taking meloxicam, alternative options such as acetaminophen (Tylenol) or other pain management strategies should be considered under the guidance of a healthcare provider.
Evidence Summary
The most recent and highest quality study on the topic of NSAID use and safety is from 2021, which discusses the efficacy and safety of single-dose intravenous ketorolac for acute postoperative pain in adults 4. However, the key consideration in this scenario is the safety of combining NSAIDs, for which the evidence consistently warns against due to increased risks of adverse effects 5, 3, 6, 2.
Recommendations
- Do not administer ketorolac after taking meloxicam without consulting a healthcare provider due to the potential for serious side effects.
- Consider alternative pain management options if additional relief is needed while on meloxicam.
- Always allow sufficient time between stopping one NSAID before starting another, typically at least 24 hours or longer, depending on the specific medications and individual health factors.