Can You Drink Alcohol With Ketorolac?

Ketorolac (Toradol) is a medication that treats moderate to severe pain. It provides similar pain relief to opioids. You shouldn’t take ketorolac for more than a total of 5 days. This applies to the IV version and nasal spray (Sprix). Ketorolac eye drops (Acular, Acular LS, Acuvail) should only be taken up to 4 days after eye surgery.

Ketorolac is a non-steroidal anti-inflammatory drug (NSAID). You may have heard of medications like naproxen (Aleve, Naprosyn) and ibuprofen (Motrin, Advil), which are also NSAIDs. All NSAIDs, including ketorolac, have risks. One of these risks is an increased chance of bleeding. And the risk is even higher if you drink alcohol.

Can you take ketorolac with alcohol?

It’s best to avoid drinking alcohol while taking ketorolac. Mixing ketorolac and alcohol raises your risk of gastrointestinal (GI) bleeds. GI bleeding can start anywhere along the GI tract, from the mouth to the anus. 

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Taking ketorolac and drinking alcohol can also raise your risk of a GI ulcer. These are sores that may occur in the lining of the stomach (peptic ulcers) or in the intestines.

What are the serious risks of combining ketorolac and alcohol?

GI bleeding from combining ketorolac and alcohol can cause serious complications, especially if it’s not treated. Complications include:

• Heart attack

• Infections

• Trouble breathing

• Shock

If GI ulcers are left untreated, they can also cause serious complications. Ulcers can penetrate (enter) other organs. Or they can progress to a complete hole (perforation) in the stomach or intestinal lining. This can be very serious and cause life-threatening infections.

Is having one or two drinks OK?

Unfortunately, there’s no clear advice on whether drinking any amount of alcohol with NSAIDs is safe. And we don’t know exactly how much alcohol it would take to increase your risk of bleeding and ulcers. Alcohol also affects everyone differently, which makes it even harder to say whether any amount of alcohol is safe with ketorolac.

If you are considering drinking alcohol while taking ketorolac, make sure to talk to your healthcare provider first. They can help you understand whether you have other risk factors for GI bleeds that might make drinking alcohol even more hazardous.

Are some people more at risk when combining alcohol and ketorolac?

Besides drinking alcohol, other factors can increase your risk of developing a GI bleed or ulcer. If you have any of these risk factors, combining ketorolac and alcohol is even more dangerous:

• Taking other medications that raise bleeding risk, like corticosteroids or anticoagulants

• Smoking

• Older age

• Having a generally poor health status

People with a high risk of bleeding should avoid alcohol entirely. This includes people who:

• Have active peptic ulcer disease

• Have a history of GI bleeds or ulcers 

• Have severe kidney damage

• Are about to have a major surgery

• Take other NSAIDs

When can you drink alcohol after stopping ketorolac?

In a typical adult with normally functioning kidneys, ketorolac lasts in the body for about 24 hours. So it’s best to wait at least 24 hours after your last ketorolac dose before having a drink. Adults who are older than 65 may want to wait at least 48 hours (2 days) after their last ketorolac dose before having alcohol. As you age, ketorolac may last longer in your body.

People with mild to moderate kidney damage may need to wait even longer, and people with severe kidney problems shouldn’t take ketorolac. Ketorolac is removed by the kidneys, so if your kidneys don’t function well, it's harder for them to process ketorolac. This can lead to toxicity.

If you recently stopped taking ketorolac, talk to your healthcare provider about when it’s safe for you to have a drink. It will depend on your existing medical conditions, age, and general health status.

How does alcohol interact with ketorolac?

Ketorolac and alcohol don’t directly interact with each other. However, the combination of these substances can have “additive” side effects. This means that ketorolac and alcohol can cause bleeding individually, and when used together, the risk is even higher. 

Alcohol alone can increase your bleeding risk because it affects the production of platelets. Platelets are blood cell fragments that help your blood clot. People who drink heavily may have less platelets, and the platelets they do have may not work as well. This can lead to bleeding. Alcohol can also directly damage your stomach lining, which can cause irritation and lead to bleeding or ulcers.

NSAIDs also affect how platelets work, making bleeding more likely.

How do you know if you have a GI bleed?

A GI bleed doesn’t always cause obvious symptoms. But some possible symptoms include (these can also be symptoms of other medical conditions):

• Dizziness

• Weakness or feeling faint

• Abdominal cramps

• Shortness of breath 

• Blood tests showing anemia

However, some signs of GI bleed might be more noticeable, such as:

• Black or red-colored stool

• Bloody vomit

• Vomit that looks like ground-up coffee

In rare cases, serious GI bleeds can cause shock. This is an emergency situation. If you experience any of the symptoms below, seek emergency care:

• A sudden drop in blood pressure

• Fast heartbeat

• Less frequent urination or none at all

• Unconsciousness

How do you know if you have a GI ulcer?

Just like a GI bleed, some signs and symptoms of GI ulcers can be caused by many other medical conditions. 

The most common symptom of ulcers is pain. This could be pain or discomfort in your abdomen. It may get worse on an empty stomach and could also worsen a few hours after eating a meal. Other symptoms include:

• Reduced appetite or weight loss

• Feeling full quickly

• Acid reflux

• Heartburn

• Nausea

• Vomiting 

The signs of a GI bleed discussed above are also potential signs of bleeding from an ulcer. If you have any bleeding, contact your healthcare provider right away. And if you have any signs of shock, seek emergency care.

When should you get medical attention?

If you experience any serious signs of bleeding or shock, call 911 or seek immediate medical attention. If you experience other symptoms of GI bleeding or ulcers like reduced appetite, weakness, or abdominal cramps, contact your healthcare provider so they can evaluate further.

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Written by:

Makaela Premont, PharmD

Makaela Premont, PharmD, is a pharmacist and the founder of uniquelymickie.com, a website dedicated to helping pharmacy students and pharmacists create a life that they enjoy. She received her Doctorate of Pharmacy from the University of South Carolina and is a licensed pharmacist in North Carolina.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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