Toradol IM Side Effects

Generic name: ketorolac

Medically reviewed by Drugs.com. Last updated on Jun 13, 2024.

Note: This document provides detailed information about Toradol IM Side Effects associated with ketorolac. Some dosage forms listed on this page may not apply specifically to the brand name Toradol IM.

Applies to ketorolac: nasal spray.

Other dosage forms:

• solution, tablet

Important warnings This medicine can cause some serious health issues

Nasal route (spray)

Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.

This risk may occur early in treatment and may increase with duration of use.

Ketorolac tromethamine is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.

NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal.

These events can occur at any time during use and without warning symptoms.

Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

Serious side effects of Toradol IM

Along with its needed effects, ketorolac (the active ingredient contained in Toradol IM) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking ketorolac:

More common

• bloody or black, tarry stools
• dizziness
• fast, irregular, pounding, or racing heartbeat or pulse
• headache
• nausea
• nervousness
• pale skin
• pounding in the ears
• severe stomach pain
• stomach cramping or burning
• sweating
• unusual bleeding or bruising
• unusual tiredness or weakness
• vomiting of blood or material that looks like coffee grounds

Less common

• burning feeling in the chest or stomach
• chest pain or discomfort
• decrease in the amount or frequency of urine
• difficult or labored breathing
• frequent urination
• lightheadedness, dizziness, or fainting
• rapid or shallow breathing

Rare

• bloody, cloudy, or dark urine
• clay-colored stools
• confusion
• difficult, burning, or painful urination
• difficulty with swallowing
• extreme tiredness or weakness
• hives, itching, or skin rash
• lower back or side pain
• nosebleeds
• swelling of the face, fingers, feet, or lower legs
• swollen glands
• tightness in the chest
• unpleasant breath odor
• upper right abdominal or stomach pain
• vomiting
• weight gain or loss
• yellow eyes or skin

Incidence not known

• blistering, peeling, or loosening of the skin
• difficulty with moving
• difficulty with speaking
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• general body swelling
• joint or muscle pain
• pain or discomfort in the arms, jaw, back, or neck
• pains in the stomach, side, or abdomen, possibly radiating to the back
• pale or blue lips, fingernails, or skin
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• redness, soreness, or itching skin
• severe mood or mental changes
• sneezing
• sores, welts, or blisters
• swollen, painful, or tender lymph glands in the neck, armpit, or groin
• weakness or heaviness of the legs

Other side effects of Toradol IM

Some side effects of ketorolac may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• belching
• continuing ringing or buzzing or other unexplained noise in the ears
• drowsiness
• feeling of fullness
• hearing loss
• nasal discomfort
• passing gas
• swelling or inflammation of the mouth

Less common

• runny nose
• stuffy nose
• watering of the eyes

Rare

• abnormal dreams
• abnormal taste
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• excessive thirst
• inability to concentrate
• irritability or restlessness
• muscle trembling, jerking, or stiffness
• redness, swelling, or soreness of the tongue
• seeing, hearing, or feeling things that are not there
• sensation of spinning
• shakiness in the legs, arms, hands, or feet
• trouble concentrating
• trouble sleeping
• uncontrolled movements, especially of the face, neck, and back

Incidence not known

• burning, dry, or itching eyes
• eye discharge or excessive tearing
• redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
• stiff neck or back

For healthcare professionals

Applies to ketorolac: injectable solution, intramuscular solution, nasal spray, oral tablet.

General

The most common adverse reactions among patients treated with ketorolac (the active ingredient contained in Toradol IM) include abdominal pain, nausea, dyspepsia, and headaches. For patients receiving the nasal spray, nasal discomfort, rhinalgia, increased lacrimation, throat irritation, and rhinitis were reported.^[Ref]

Gastrointestinal

• Very common (10% or more): Abdominal pain, dyspepsia, nausea
• Common (1% to 10%): Constipation, diarrhea, flatulence, gastrointestinal (GI) fullness, GI ulcers (gastric/duodenal), gross bleeding/perforation, heartburn, stomatitis, vomiting, throat irritation (nasal spray)
• Frequency not reported: Anorexia, dry mouth, eructation, esophagitis, excessive thirst, gastritis, glossitis, hematemesis, melena, rectal bleeding, increased appetite, peptic ulcers, ulcers, hematemesis, gastritis
• Postmarketing reports: Acute pancreatitis, liver failure, ulcerative stomatitis, exacerbation of inflammatory bowel disease (ulcerative colitis, Crohn's disease), eructation^[Ref]

A large postmarketing observational study (n=10,000) revealed the incidence of clinically serious gastrointestinal (GI) bleeding was dose dependent and more than double in patients 65 years or older. The incidence of clinically serious GI bleeding after up to 5 days of treatment with doses of 60 mg or less, greater than 60 to 90 mg, greater than 90 to 120 mg, or greater than 120 mg, respectively was 0.4%, 0.4%, 0.9%, and 4.6% in those less than 65 years compared with 1.2%, 2.8%, 2.2%, and 7.7% in those 65 years or older. Among patients with a history of GI perforation, ulcer, or bleeding, these numbers were 2.1%, 4.6%, 7.8%, and 15.4% compared with 4.7%, 3.7%, 2.8%, and 25%, in younger and older patients, respectively.^[Ref]

Hematologic

• Common (1% to 10%): Anemia, increased bleeding time
• Frequency not reported: Bleeding, hematoma, postoperative wound hemorrhage
• Postmarketing reports: Agranulocytosis, aplastic anemia, hemolytic anemia, lymphadenopathy, pancytopenia, thrombocytopenia purpura, thrombocytopenia, neutropenia, postoperative wound hemorrhage (rarely requiring blood transfusion)^[Ref]

Serious events of bleeding (n=4) or hematoma (n=3) at the operative site were reported in controlled clinical trials in patients (n=455) undergoing major surgeries (primarily knee and hip replacements, and abdominal hysterectomies) receiving ketorolac nasal spray compared with 1 patient in the placebo group (hematoma).

In pediatric patients, an increased risk of bleeding was observed following tonsillectomy. In a retrospective analysis, risk of bleeding following a tonsillectomy with or without adenoidectomy was 10.1% in patients receiving this drug compared with 2.2% in those receiving opioids. The postoperative hemorrhage rate in patients 12 years and younger was 6.5% with ketorolac treatment versus 3.3% without. In a prospective study in patients 3 to 9 years undergoing tonsillectomy with or without adenoidectomy, the overall incidence of bleeding in patients receiving this drug was 16.3% compared with 17% in children receiving morphine. However, during the first 24 hours after surgery, bleeding was observed in 14.3% of the ketorolac group versus 4.2% of the morphine group.^[Ref]

Cardiovascular

• Common (1% to 10%): Edema, hypertension, bradycardia
• Frequency not reported: Congestive heart failure, palpitations, pallor, tachycardia, syncope, cardiac failure
• Postmarketing reports: Arrhythmia, chest pain, flushing, hypotension, myocardial infarction, vasculitis^[Ref]

Clinical trials of several cyclooxygenase (COX)-2 selective and nonselective NSAIDs of up to 3 years duration have shown an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. All NSAIDs appear to have a similar risk. There is no consistent evidence that concurrent use of aspirin mitigates this increased risk and may be associated with an increased risk of serious gastrointestinal events.^[Ref]

Dermatologic

• Common (1% to 10%): Rash, pruritus, purpura, sweating

Very rare (less than 0.01%):

• Frequency not reported: Alopecia, photosensitivity, urticaria
• Postmarketing reports: Angioedema, exfoliative dermatitis, erythema multiforme, Lyell's syndrome, bullous reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis^[Ref]

Hypersensitivity

• Frequency not reported: Anaphylactoid reactions
• Postmarketing reports: Laryngeal edema, tongue edema^[Ref]

Renal

• Common (1% to 10%): Abnormal renal function, oliguria
• Postmarketing reports: Acute renal failure, nephrotic syndrome^[Ref]

Hepatic

• Common (1% to 10%): Elevated liver enzymes
• Frequency not reported: Hepatitis, jaundice, liver failure^[Ref]

Metabolic

• Frequency not reported: Weight change
• Postmarketing reports: Hyperglycemia, hyperkalemia, hyponatremia^[Ref]

Respiratory

• Very common (10% or more): Nasal discomfort (15%, nasal spray), rhinalgia (13%, nasal spray)
• Common (1% to 10%): Rhinitis (nasal spray)
• Frequency not reported: Epistaxis, pulmonary edema, asthma
• Postmarketing reports: Bronchospasm, respiratory depression, pneumonia^[Ref]

Nervous system

• Very common (10% or more): Headaches
• Common (1% to 10%): Drowsiness, dizziness
• Frequency not reported: Extrapyramidal symptoms, hyperkinesis, inability to concentrate, insomnia, paresthesia, somnolence, stupor, tremors
• Postmarketing reports: Aseptic meningitis, convulsions, coma, taste abnormality^[Ref]

Local

• Common (1% to 10%): Injection site pain^[Ref]

Ocular

• Common (1% to 10%): Lacrimation increased (nasal spray)
• Postmarketing reports: Conjunctivitis, optic neuritis, visual disturbances, abnormal vision^[Ref]

Psychiatric

• Frequency not reported: Anxiety, depression, euphoria, hallucinations, abnormal dreams, abnormal thinking
• Postmarketing reports: Psychosis^[Ref]

Other

• Common (1% to 10%): Tinnitus
• Frequency not reported: Fever, asthenia, malaise, vertigo, hearing loss^[Ref]

Endocrine

• Frequency not reported: Female infertility^[Ref]

Genitourinary

• Postmarketing reports: Flank pain with or without hematuria and/or azotemia, hemolytic uremia syndrome, increased urinary frequency, oliguria, interstitial nephritis, urinary retention^[Ref]

Immunologic

• Frequency not reported: Infections, sepsis^[Ref]

Musculoskeletal

• Postmarketing reports: Myalgia^[Ref]

Frequently asked questions

• How and where is the Toradol injection given?
• Which painkiller should you use?
• How long does ketorolac (Toradol) stay in your system?

Further information

Toradol IM side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer