Pain Home > Sprix Drug Interactions
Using medications such as ACE inhibitors, muscle relaxants, or lithium in combination with Sprix may lead to negative drug interactions. Some of these reactions can alter the amounts of the medications in your blood, possibly decreasing the effectiveness of the drugs or causing potentially serious side effects. Make sure your healthcare provider is aware of any other medications or herbal supplements you are taking.
An Overview of Interactions With Sprix
Sprix™ (ketorolac nasal spray) may potentially react with a number of other medications. Some of the drugs that may lead to interactions with Sprix include but are not limited to:- ACE inhibitors, such as:
- Benazepril (Lotensin®, Lotensin® HCT, Lotrel®)
- Captopril (Capoten®, Capozide®)
- Enalapril (Vasotec®, Vaseretic®, Lexxel®)
- Fosinopril (Monopril®, Monopril-HCT®)
- Lisinopril (Prinivil®, Prinizide®, Zestril®, Zestoretic®)
- Quinapril (Accupril®, Accuretic®)
- Ramipril (Altace®)
- Angiotensin II receptor blockers (ARBs), such as:
- Azilsartan (Edarbi™) or azilsartan/chlorthalidone (Edarbyclor™)
- Candesartan (Atacand®) or candesartan-hydrochlorothiazide (Atacand HCT®)
- Eprosartan (Teveten®) or eprosartan-hydrochlorothiazide (Teveten® HCT)
- Irbesartan (Avapro®) or irbesartan-hydrochlorothiazide (Avalide®)
- Losartan (Cozaar®) or losartan-hydrochlorothiazide (Hyzaar®)
- Olmesartan (Benicar®), olmesartan-hydrochlorothiazide (Benicar HCT®), or amlodipine and olmesartan (AZOR™)
- Telmisartan (Micardis®) or telmisartan-hydrochlorothiazide (Micardis® HCT)
- Valsartan (Diovan®) or valsartan-hydrochlorothiazide (Diovan HCT®)
- Diuretics, such as:
- Amiloride (Midamor®) or amiloride-HCTZ (Moduretic®)
- Bumetanide (Bumex®)
- Chlorothiazide (Diuril®)
- Chlorthalidone (Thalitone®)
- Ethacrynic acid (Edecrin®)
- Furosemide (Lasix®)
- Hydrochlorothiazide (Esidrix®, HydroDIURIL®, Microzide®, Oretic®)
- Metolazone (Zaroxolyn®)
- Spironolactone (Aldactone®) or spironolactone-HCTZ (Aldactazide®)
- Torsemide (Demadex®)
- Triamterene (Dyrenium®) or triamterene/HCTZ (Dyazide®, Maxzide®)
- Corticosteroids, including (but not limited to):
- Betamethasone (Celestone®)
- Cortisone
- Dexamethasone (Decadron®)
- Fludrocortisone (Florinef®)
- Hydrocortisone (Cortef®)
- Methylprednisolone (Depo-Medrol®, Medrol®)
- Prednisolone (Orapred®, Pediapred®)
- Prednisone
- Triamcinolone (Kenalog®, Aristospan®)
- Cyclosporine (Gengraf®, Neoral®, Sandimmune®)
- Digoxin (Digitek®, Lanoxin®)
- Lithium (Eskalith®, Lithane®, Lithonate®, Lithotabs®)
- Medications that "thin" the blood (such as anticoagulant and antiplatelet drugs), such as:
- Antithrombin (ATryn®, Thrombate III®)
- Apixaban (Eliquis®)
- Argatroban
- Aspirin (Bayer® and others)
- Bivalirudin (Angiomax®)
- Cilostazol (Pletal®)
- Clopidogrel (Plavix®)
- Dabigatran (Pradaxa®)
- Dipyridamole (Persantine®)
- Drotrecogin alfa (Xigris®)
- Eptifibatide (Integrilin®)
- Fondaparinux (Arixtra®)
- Heparin or heparin-like products, including dalteparin (Fragmin®), enoxaparin (Lovenox®), or tinzaparin (Innohep®)
- Lepirudin (Refludan®)
- Other nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
- Celecoxib (Celebrex®)
- Diclofenac (Cambia™, Cataflam®, Flector®, Solaraze® Gel, Voltaren®, Voltaren® Gel, Voltaren®-XR, Voltaren Ophthalmic®, Zipsor™)
- Etodolac (Lodine®, Lodine® XL)
- Ibuprofen (Motrin®, Advil®, Nuprin®)
- Indomethacin (Indocin®, Indocin SR®)
- Ketoprofen (Orudis®, Actron®, Oruvail®)
- Ketorolac (Toradol®)
- Meloxicam (Mobic®)
- Nabumetone (Relafen®)
- Naproxen (Naprosyn®) or naproxen sodium (Aleve®, Anaprox®, Naprelan®)
- Oxaprozin (Daypro®)
- Piroxicam (Feldene®)
- Others (see List of NSAIDs for a more complete list of these medications)
- Pentoxifylline (Trental®)
- Prasugrel (Effient®)
- Rivaroxaban (Xarelto®)
- Thrombolytics, such as:
- Alteplase (Activase®)
- Reteplase (Retavase®)
- Streptokinase (Streptase®)
- Tenecteplase (TNKase®)
- Ticagrelor (Brilinta®)
- Ticlopidine (Ticlid®)
- Tirofiban (Aggrastat®)
- Warfarin (Coumadin®, Jantoven®)
- Methotrexate (Rheumatrex®, Trexall™)
- Pentoxifylline (Trental®, Pentoxil®)
- Probenecid (Benemid®, Probalan®)
- Psychoactive drugs, such as thiothixene (Navane®) or alprazolam (Xanax®, Xanax XR®, Niravam™)
- Seizure medicines, such as phenytoin (Dilantin®, Phenytek®) or carbamazepine (Carbatrol®, Epitol®, Tegretol®, Tegretol®-XR, Equetro™)
- SSRI or SNRI medications, such as:
- Citalopram (Celexa®)
- Duloxetine (Cymbalta®)
- Desvenlafaxine (Pristiq®)
- Escitalopram (Lexapro®)
- Fluoxetine (Prozac®, Sarafem®, Selfemra™)
- Fluvoxamine (Luvox®, Luvox® CR)
- Levomilnacipran (Fetzima™)
- Milnacipran (Savella™)
- Paroxetine (Paxil®, Paxil CR®, Pexeva®, Brisdelle™)
- Sertraline (Zoloft®)
- Venlafaxine (Effexor®, Effexor XR®)
- Several herbal and nutritional supplements, such as:
- Dong quai
- Feverfew
- Garlic
- Ginger
- Ginkgo biloba
- Ginseng
- Fish oil supplements
- St. John's wort (Hypericum perforatum).