Ketorolac

Pronunciation

Generic Name: ketorolac (KEE-toe-ROLE-ak)
Brand Name: Toradol

Ketorolac is only intended for short-term (up to 5 days) treatment of moderately severe pain. It should not be used to treat minor or long-term pain. Do not use more of ketorolac than prescribed. Do not use ketorolac to treat children.

Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID). It may cause an increased risk of serious and sometimes fatal heart and blood vessel problems (eg, heart attack, stroke). The risk may be greater if you already have heart problems or if you take ketorolac for a long time. Do not use ketorolac right before or after coronary artery bypass graft (CABG).

Ketorolac may cause an increased risk of serious and sometimes fatal stomach ulcers and bleeding. Elderly patients may be at greater risk. This may occur without warning signs.

Do not use ketorolac if:

  • you are allergic to ketorolac, aspirin, or any other NSAIDs (eg, ibuprofen, celecoxib)
  • you are taking aspirin or another NSAID (eg, ibuprofen, celecoxib)
  • you are breast-feeding or are in labor
  • you have recently had or will be having CABG
  • you have a stomach ulcer or a history of ulcers or severe stomach problems (eg, bleeding, perforation)
  • you have severe kidney problems or are at risk of kidney failure (eg, low blood volume, dehydrated)
  • you have bleeding in the brain (eg, stroke, aneurysm) or bleeding problems (eg, platelet disorder, hemophilia), or you are at risk of bleeding

Do not use ketorolac to prevent pain before any major surgery.


Ketorolac is used for:

The short-term (up to 5 days) treatment of moderately severe pain (usually after surgery), alone or in combination with other medicines.

Ketorolac is an NSAID. Exactly how it works is not known. It may block certain substances in the body that are linked to inflammation. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes these symptoms.

Do NOT use ketorolac if:

  • you are allergic to any ingredient in ketorolac
  • you have had a severe allergic reaction (eg, severe rash, hives, breathing difficulties, dizziness) to aspirin or an NSAID (eg, ibuprofen, naproxen, celecoxib)
  • you are taking pentoxifylline, probenecid, aspirin, or another NSAID (eg, ibuprofen, celecoxib)
  • you are in the last 3 months of pregnancy, are breast-feeding, or are in labor
  • you have recently had or will be having CABG or you have a stomach ulcer or a history of ulcers or severe stomach problems (eg, bleeding, perforation)
  • you have severe kidney problems or are at risk of kidney failure (eg, low blood volume, dehydrated)
  • you have bleeding in the brain (eg, stroke, aneurysm) or bleeding problems (eg, platelet disorder, hemophilia), or you are at risk of bleeding
  • you need to prevent pain before any major surgery

Contact your doctor or health care provider right away if any of these apply to you.

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Before using ketorolac:

Some medical conditions may interact with ketorolac. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of kidney or liver problems, diabetes, or stomach or bowel problems (eg, bleeding, perforation, ulcers, Crohn disease)
  • if you have a history of swelling or fluid buildup, asthma, growths in the nose (nasal polyps), or mouth inflammation
  • if you have high blood pressure, blood disorders (eg, porphyria), bleeding or clotting problems, heart problems (eg, heart failure), or blood vessel disease, or you are at risk of any of these diseases
  • if you have poor health, dehydration or low fluid volume, or low blood sodium levels, you smoke, drink alcohol, or have a history of alcohol abuse

Some MEDICINES MAY INTERACT with ketorolac. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Anticoagulants (eg, warfarin), aspirin, clopidogrel, corticosteroids (eg, prednisone), heparin and other blood thinners (eg, dalteparin), pentoxifylline, or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) because the risk of bleeding may be increased
  • Probenecid because it may increase the risk of ketorolac's side effects
  • Cyclosporine, lithium, metformin, methotrexate, oral NSAIDs (eg, ibuprofen), or quinolones (eg, ciprofloxacin) because the risk of their side effects may be increased by ketorolac
  • Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril) or diuretics (eg, furosemide, hydrochlorothiazide) because their effectiveness may be decreased by ketorolac

This may not be a complete list of all interactions that may occur. Ask your health care provider if ketorolac may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use ketorolac:

Use ketorolac as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Ketorolac comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get ketorolac refilled.
  • Ketorolac is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using ketorolac at home, a health care provider will teach you how to use it. Be sure you understand how to use ketorolac. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
  • Ketorolac will not be given for more than 5 days. Ketorolac is not for the treatment of mild to moderate or chronic pain (eg, headache).
  • Do not use ketorolac if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you miss a dose of ketorolac and you are using it regularly, use it as soon as possible. If it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use ketorolac.

Important safety information:

  • Ketorolac may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use ketorolac with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Serious stomach ulcers or bleeding can occur with the use of ketorolac. Taking it in high doses or for a long time, smoking, or drinking alcohol increases the risk of these side effects. Taking ketorolac with food will NOT reduce the risk of these effects. Contact your doctor or emergency room at once if you develop severe stomach or back pain; black, tarry stools; vomit that looks like blood or coffee grounds; or unusual weight gain or swelling.
  • Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
  • Ketorolac is an NSAID. Before you start any new medicine, check the label to see if it has an NSAID (eg, ibuprofen) in it too. If it does or if you are not sure, check with your doctor or pharmacist.
  • Do not take aspirin while you are using ketorolac unless your doctor tells you to.
  • Check with your doctor or pharmacist before you take acetaminophen while you are taking ketorolac. The risk of liver problems may be increased.
  • Lab tests, including kidney function, liver function, blood electrolyte levels, complete blood cell counts, and blood pressure, may be performed while you use ketorolac. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use ketorolac with caution in the ELDERLY; they may be more sensitive to its effects, especially stomach bleeding and kidney problems.
  • Ketorolac should not be used in CHILDREN younger than 16 years old; safety and effectiveness in these children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Ketorolac may cause harm to the fetus. Do not use it during the last 3 months of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using ketorolac while you are pregnant. Ketorolac is found in breast milk. Do not breast-feed while taking ketorolac.

Possible side effects of ketorolac:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; gas; headache; indigestion; mild stomach pain or upset; nausea; pain at the injection site; stomach fullness; sweating; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue, unusual hoarseness); bloody or black, tarry stools; bloody or cloudy urine; change in the amount of urine produced or trouble urinating; chest pain; confusion; dark urine; depression; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; hallucinations; mental or mood changes; mouth sores; numbness of an arm or leg; one-sided weakness; persistent flu-like symptoms; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe headache or dizziness; severe or persistent stomach pain or nausea; severe vomiting or diarrhea; shortness of breath; sudden or unexplained weight gain; swelling of the arms, hands, legs, or feet; unusual bruising or bleeding; unusual joint or muscle pain; unusual tiredness or weakness; vision or speech changes; vomit that looks like coffee grounds; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include decreased urination; loss of consciousness; seizures; severe dizziness or drowsiness; severe nausea or stomach pain; slow or troubled breathing; tremor; unusual bleeding or bruising; vomit that looks like coffee grounds.

Proper storage of ketorolac:

Store ketorolac at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep ketorolac, as well as syringes and needles, out of the reach of children and away from pets.

General information:

  • If you have any questions about ketorolac, please talk with your doctor, pharmacist, or other health care provider.
  • Ketorolac is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take ketorolac or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about ketorolac. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to ketorolac. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using ketorolac.

Issue Date: April 2, 2014
Database Edition 14.2.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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