What the FDA labels say about taking them together
Ketorolac and pemetrexed
Ketorolac's FDA label (Sprix) of December 5, 2024 names pemetrexed in its drug interactions section; the pemetrexed labels PlainMeds reads (4) do not name ketorolac. The ketorolac label: “Concomitant use of SPRIX and pemetrexed may increase the risk of pemetrexed-associated myelosuppression, renal, and GI toxicity.”
Check it at the source: the ketorolac FDA label on DailyMed (effective August 31, 2023, Fresenius Kabi USA, LLC); the pemetrexed FDA label on DailyMed (effective October 8, 2025, Avyxa Pharma, LLC).
What does the ketorolac label say about pemetrexed?
Sprix label (Zyla Life Sciences US LLC, December 5, 2024), drug interactionsPemetrexed Clinical Impact: Concomitant use of SPRIX and pemetrexed may increase the risk of pemetrexed-associated myelosuppression, renal, and GI toxicity (…). Intervention: During concomitant use of SPRIX and pemetrexed, in patients with renal impairment whose creatinine clearance ranges from 45 to 79 mL/min, monitor for myelosuppression, renal and GI 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 pemetrexed label say about ketorolac?
Pemetrexed's label (effective October 8, 2025) and its 3 other brand-application labels do not name ketorolac in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (AXTLE), Avyxa Pharma, LLC, effective October 8, 2025 (SPL set 9582c46c-d8b0-44b7-a2ee-9c86f5e9b7b1), 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 | Pemetrexed | |
|---|---|---|
| Labeled for | Pain | Lung cancer |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | $1.02 per mL 30 mg/mL vial | n/a |
| Shortage now | In shortage | A presentation being discontinued |
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