Ketorolac use while Breastfeeding

Drugs containing Ketorolac: Toradol, Acular, Toradol IV/IM, Toradol IM, Sprix, Acular LS, Acuvail, Acular PF, Omidria

Ketorolac Levels and Effects while Breastfeeding

Summary of Use during Lactation

Limited data indicate that milk levels of ketorolac are low with the usual oral dosage, but milk levels have not been measured after higher injectable dosages. Use caution when using ketorolac in nursing mothers, especially with the injectable drug. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.

Drug Levels

Maternal Levels. Ten women who were 2 to 6 days postpartum and were taking ketorolac 10 mg orally four times daily had their milk ketorolac levels measured at various times during 2 days of drug administration. Milk levels were undetectable (<5 mcg/L) in 4 of the patients at all collection times. In the other 6 patients, ketorolac was detectable 2 hours after the first dose of the day in concentrations from 5.2 to 7.3 mcg/L on day 1 and from 5.9 to 7.9 mcg/L on day 2. Ketorolac was not detectable in milk in any patient 10 hours after the last dose.[1] The paper erroneously states that the breastfed infant would receive an estimated 3.16 to 7.9 mg daily based on a calculation error. The correct calculation yields an estimated maximum daily intake of 7.9 mcg or 0.18% of the maternal weight-adjusted dosage.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Possible Effects on Lactation

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Acetaminophen, Flurbiprofen, Ibuprofen, Indomethacin, Naproxen, Piroxicam

References

1. Wischnik A, Manth SM, Lloyd J et al. The excretion of ketorolac tromethamine into breast milk after multiple oral dosing. Eur J Clin Pharmacol. 1989;36:521-4. PMID: 2787750

Ketorolac Identification

Substance Name

Ketorolac

CAS Registry Number

74103-06-3

Drug Class

  • Analgesic Agents
  • Nonsteroidal Antiinflammatory Agents

Administrative Information

LactMed Record Number

153

Information from the National Library of Medicine's LactMed Database.

Last Revision Date

2013-10-22

Disclaimer

Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

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