Generic Name: ketorolac (nasal) (KEE toe ROLE ak (NAY sul))
Brand Names: Sprix

What is Sprix nasal spray?

Sprix nasal spray (ketorolac) is a non steroidal anti inflammatory drug (NSAID). This medicine works by reducing substances in the body that cause pain, fever, and inflammation.

Sprix nasal spray is used short-term (5 days or less) to treat moderate to severe pain.

Sprix nasal spray may also be used for purposes not listed in this medication guide.

Important information

Do not use Sprix nasal spray for longer than 5 days. You should not use Sprix nasal spray if you have severe kidney disease, a bleeding or blood clotting disorder, bleeding in your brain, a stomach ulcer or history of stomach bleeding, or if you are breast-feeding a baby.

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Ketorolac may increase your risk of heart attack or stroke, especially if you use it long term or have heart disease. Do not use this Sprix nasal spray just before or after any surgery, especially heart bypass surgery (coronary artery bypass graft, or CABG).

Ketorolac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using Sprix nasal spray.

Pentoxifylline or probenecid can interact with ketorolac and should not be used at the same time.

Before taking this medicine

Ketorolac may increase your risk of heart attack or stroke, especially if you use it long term or have heart disease. Do not use Sprix nasal spray just before or after any surgery, especially heart bypass surgery (coronary artery bypass graft, or CABG).

Ketorolac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using Sprix nasal spray, especially in older adults.

You should not use Sprix nasal spray if you are allergic to ketorolac, or if you have:

  • severe kidney disease;

  • a bleeding or blood clotting disorder;

  • asthma, or "aspirin triad syndrome," a severe allergic reaction caused by taking aspirin, or other NSAIDs (Advil, Aleve, Celebrex, Indocin, Naprosyn, Orudis, Voltaren, and others);

  • a closed head injury or bleeding in your brain;

  • a stomach ulcer, perforation, or a history of stomach or intestinal bleeding; or

  • if you are breast-feeding a baby.

Pentoxifylline or probenecid can interact with ketorolac and should not be used at the same time.

Do not use Sprix nasal spray if you are already taking aspirin or other NSAIDs, or using other forms of ketorolac (such as injections or pills you take by mouth).

To make sure Sprix nasal spray is safe for you, tell your doctor if you have:

  • a history of heart attack, stroke, or blood clot;

  • heart disease, congestive heart failure, high blood pressure;

  • liver or kidney disease,

  • ulcerative colitis or Crohn's disease;

  • polyps in your nose;

  • if you take a blood thinner (warfarin, Coumadin);

  • if you have recently had surgery; or

  • if you smoke.

FDA pregnancy category D. Sprix nasal spray may be harmful to an unborn baby if the mother uses the medication after 30 weeks of pregnancy. Using Sprix nasal spray during labor can increase the risk of bleeding during childbirth. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

See also: Pregnancy and breastfeeding warnings (in more detail)

Ketorolac nasal can pass into breast milk and may harm a nursing baby. Do not breast feed a baby while using Sprix nasal spray.

Do not give Sprix nasal spray to anyone younger than 18 years old.

How should I use Sprix nasal spray?

Take Sprix exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use Sprix in larger or smaller amounts or for longer than recommended.

Sprix comes with patient instructions for safe use, and directions for priming the nasal spray. Ask your doctor or pharmacist if you have any questions.

Sprix nasal spray is usually given every 6 to 8 hours. Follow your doctor's instructions.

To use the Sprix nasal spray spray:

  • Gently blow your nose before using the Sprix nasal spray.

  • The first time you use a new bottle, remove the clip and plastic cover and prime the unit by pumping 5 sprays into the air, away from your face, until a fine mist appears.

  • Tilt your head forward slightly and insert the tip of bottle into your nostril, pointing it away from the center of your nose. Breathe through your mouth while spraying gently into your nostril. Do not inhale or sniff while spraying. If your nose runs, gently sniff to keep the nasal spray from leaking out.

  • Use only the number of sprays prescribed by your doctor.

  • Put the plastic cap back on the Sprix bottle and store it in a dry place, out of direct sunlight.

Avoid getting Sprix nasal spray in your eyes. If this does happen, rinse with water or saline solution. Call your doctor if you have eye irritation for longer than 1 hour.

Do not use this Sprix nasal sprayfor longer than 5 days unless your doctor has told you to.

Each bottle of this medicine contains 8 sprays for use within a 24-hour period. Throw the bottle away within 24 hours after your first use, even if there is still some medicine left in the bottle.

Store the unopened nasal spray bottles in a refrigerator. Do not freeze.

After opening a Sprix nasal spray bottle, store it at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Sprix nasal spray?

Ask your doctor before using Sprix nasal spray if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Ask a doctor or pharmacist before using any cold, allergy, or other pain medication. Many medicines available over the counter contain aspirin or other medicines similar to ketorolac. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen.

Sprix nasal spray side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Sprix: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating; or signs of a stroke--sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance.

Stop using Sprix nasal spray and call your doctor at once if you have:

  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • slow heart rate;

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  • little or no urinating;

  • swelling, rapid weight gain;

  • liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common Sprix side effects may include:

  • pain or irritation in your nose;

  • runny nose;

  • watery eyes;

  • throat irritation; or

  • mild rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Sprix nasal spray?

Other drugs may interact with ketorolac, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about Sprix nasal spray.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Sprix only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 2.01. Revision Date: 2014-01-23, 12:40:13 PM.

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