What the FDA labels say about taking them together
Ketorolac and lithium
Ketorolac's FDA label (Sprix) of December 5, 2024 names lithium in its drug interactions section; lithium's label does not name ketorolac itself but warns about its class (NSAIDs (nonsteroidal anti-inflammatory drugs)). The ketorolac label: “NSAIDs have produced elevations in plasma lithium levels and reductions in renal lithium clearance. The mean minimum lithium concentration increased 15%, and the renal clearance decreased by approximately 20%. …”
Check it at the source: the ketorolac FDA label on DailyMed (effective August 31, 2023, Fresenius Kabi USA, LLC); the lithium FDA label on DailyMed (effective December 23, 2025, Glenmark Pharmaceuticals Inc., USA).
What does the ketorolac label say about lithium?
Sprix label (Zyla Life Sciences US LLC, December 5, 2024), drug interactionsClinical Impact: NSAIDs have produced elevations in plasma lithium levels and reductions in renal lithium clearance. The mean minimum lithium concentration increased 15%, and the renal clearance decreased by approximately 20%. This effect has been attributed to NSAID inhibition of renal prostaglandin synthesis. Intervention: During concomitant use of SPRIX and lithium, monitor patients for signs of lithium toxicity.
Source: FDA drug label (Sprix, NDA022382), Zyla Life Sciences US LLC, effective December 5, 2024 (SPL set 97005a1c-167e-4676-bae7-e49b38c36f9e), via openFDA
Source: FDA drug label (Ketorolac Tromethamine), Fresenius Kabi USA, LLC, effective August 31, 2023 (SPL set 3d88cbe6-5230-47aa-80af-0c41283d1f00), via openFDA; the full label on DailyMed
What does the lithium label say about ketorolac?
Lithium's label does not name ketorolac itself; it warns about its class (NSAIDs (nonsteroidal anti-inflammatory drugs)):
Lithium label, drug interactionsDiuretics, NSAID, renin-angiotensin system antagonists, or metronidazole may increase lithium serum concentrations.
Lithium label, drug interactionsReduce lithium dosage based on serum lithium concentration and clinical response [see Dosage and Administration ( 2.3 ), Warning and Precautions ( 5.3 )]. Non-Steroidal Anti-inflammatory Drugs (NSAID)
Source: FDA drug label (Lithium Carbonate), Glenmark Pharmaceuticals Inc., USA, effective December 23, 2025 (SPL set 63b3790f-a9b5-47f4-bae1-ddf8b43c13c1), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Ketorolac | Lithium | |
|---|---|---|
| Labeled for | Pain | Bipolar disorder |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $1.02 per mL 30 mg/mL vial | $0.104 per capsule 300 mg capsule |
| Shortage now | In shortage | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once