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Toradol (oral/injection)

Pronunciation

Generic Name: ketorolac (oral/injection) (KEE toe ROLE ak)
Brand Name: Toradol

What is ketorolac?

Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID). Ketorolac works by reducing hormones that cause inflammation and pain in the body.

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

Ketorolac may also be used for purposes not listed in this medication guide.

What is the most important information I should know about ketorolac?

You should not use ketorolac if you have any active or recent bleeding (including bleeding inside your body), a head injury, a stomach ulcer, severe kidney disease, a bleeding or blood-clotting disorder, a history of severe allergic reaction to aspirin or an NSAID, if you are scheduled to have surgery, if you are in late pregnancy, or if you are breast-feeding a baby.

You should not use ketorolac if you also take pentoxifylline, probenecid, aspirin, or other NSAIDs.

Ketorolac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after 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 ketorolac, especially in older adults. You should not take this medicine if you already have bleeding in your stomach or intestines.

What should I discuss with my healthcare provider before taking ketorolac?

Ketorolac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking this medicine.

Do not use this medicine just before or after 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 ketorolac, especially in older adults.

You should not use ketorolac if you are allergic to it, or if you have:

  • active or recent stomach ulcer, stomach bleeding, or intestinal bleeding;

  • a bleeding or blood-clotting disorder;

  • a closed head injury or bleeding in your brain;

  • bleeding from a recent surgery;

  • severe kidney disease or dehydration;

  • a history of asthma or severe allergic reaction after taking aspirin or an NSAID;

  • if you are scheduled to have surgery (especially bypass surgery); or

  • if you are in late pregnancy or you are breast-feeding a baby.

Some medicines can cause unwanted or dangerous effects when used with ketorolac. Your doctor may need to change your treatment plan if you use any of the following drugs:

  • pentoxifylline;

  • probenecid; or

  • aspirin or other NSAIDs--ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

To make sure ketorolac is safe for you, tell your doctor if you have:

  • heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;

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

  • a history of stomach ulcers or bleeding;

  • inflammatory bowel disease, ulcerative colitis, or Crohn's disease;

  • liver disease;

  • kidney disease (or if you are on dialysis);

  • asthma; or

  • fluid retention.

Using ketorolac during the last 3 months of pregnancy may harm the unborn baby. Ketorolac may also increase the risk of uterine bleeding and is not for use during labor and delivery. Tell your doctor if you are pregnant.

Ketorolac can pass into breast milk and may harm a nursing baby. Do not breast-feed while using this medicine.

Ketorolac is not approved for use by anyone younger than 2 years old.

How should I take ketorolac?

Ketorolac is usually given first as an injection, and then as an oral (by mouth) medicine. The injection is given into a muscle, or into a vein through an IV. A healthcare provider will give you the injection.

Follow all directions on your prescription label. Do not take this medicine in larger amounts or for longer than recommended. Use the lowest dose that is effective in treating your condition.

Ketorolac should not be used for longer than 5 days, including both injection plus tablets. Long-term use of this medicine can damage your kidneys or cause bleeding.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

What happens if I miss a dose?

Since ketorolac is used for pain, you are not likely to miss a dose. Skip any 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 taking ketorolac?

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Ask a doctor or pharmacist before using any cold, allergy, or 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.

Ketorolac side effects

Get emergency medical help if you have signs of an allergic reaction: sneezing, runny or stuffy nose; wheezing or trouble breathing; hives; swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath.

Stop using ketorolac and call your doctor at once if you have:

  • shortness of breath (even with mild exertion);

  • swelling or rapid weight gain;

  • the first sign of any skin rash, no matter how mild;

  • signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

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

  • kidney problems--little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath;

  • low red blood cells (anemia)--pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; 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 side effects may include:

  • nausea, stomach pain, indigestion, diarrhea;

  • dizziness, drowsiness;

  • headache; or

  • swelling.

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 ketorolac?

Ask your doctor before using ketorolac 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.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • lithium;

  • methotrexate;

  • heparin or warfarin (Coumadin, Jantoven);

  • antipsychotic medicine;

  • heart or blood pressure medication, including a diuretic or "water pill";

  • seizure medicine (carbamazepine, phenytoin); or

  • steroid medicine (such as prednisone).

This list is not complete. Other drugs may interact with ketorolac, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about ketorolac.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication 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 1996-2012 Cerner Multum, Inc. Version: 9.02.

Date modified: November 30, 2016
Last reviewed: July 22, 2016

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