What are the side effects of toradol?

Toradol

SIDE EFFECTS

Adverse reaction rates increase with higher doses of TORADOL (ketorolac tromethamine) . Practitioners should be alert for the severe complications of treatment with TORADOL (ketorolac tromethamine) , such as GI ulceration, bleeding and perforation, postoperative bleeding, acute renal failure, anaphylactic and anaphylactoid reactions and liver failure (see BOXED WARNING, WARNINGS, PRECAUTIONS, and DOSAGE AND ADMINISTRATION). These NSAID-related complications can be serious in certain patients for whom TORADOL (ketorolac tromethamine) is indicated, especially when the drug is used inappropriately.

In patients taking TORADOL (ketorolac tromethamine) or other NSAIDs in clinical trials, the most frequently reported adverse experiences in approximately 1% to 10% of patients are:

Gastrointestinal (GI) experiences including:
abdominal pain* constipation/diarrhea dyspepsia*
flatulence GI fullness GI ulcers (gastric/duodenal)
gross bleeding/perforation Heartburn nausea*
stomatitis Vomiting
Other experiences:
abnormal renal function Anemia dizziness
drowsiness Edema elevated liver enzymes
headaches* Hypertension increased bleeding time
injection site pain Pruritus purpura
rashes Tinnitus sweating
*Incidence greater than 10%

Additional adverse experiences reported occasionally ( < 1% in patients taking TORADOL (ketorolac tromethamine) or other NSAIDs in clinical trials) include:

Body as a Whole: fever, infections, sepsis

Cardiovascular: congestive heart failure, palpitation, pallor, tachycardia, syncope

Dermatologic: alopecia, photosensitivity, urticaria

Gastrointestinal: anorexia, dry mouth, eructation, esophagitis, excessive thirst, gastritis, glossitis, hematemesis, hepatitis, increased appetite, jaundice, melena, rectal bleeding

Hemic and Lymphatic: ecchymosis, eosinophilia, epistaxis, leukopenia, thrombocytopenia

Metabolic and Nutritional: weight change

Nervous System: abnormal dreams, abnormal thinking, anxiety, asthenia, confusion, depression, euphoria, extrapyramidal symptoms, hallucinations, hyperkinesis, inability to concentrate, insomnia, nervousness, paresthesia, somnolence, stupor, tremors, vertigo, malaise

Reproductive, female: infertility

Respiratory: asthma, cough, dyspnea, pulmonary edema, rhinitis

Special Senses: abnormal taste, abnormal vision, blurred vision, hearing loss

Urogenital: cystitis, dysuria, hematuria, increased urinary frequency, interstitial nephritis, oliguria/polyuria, proteinuria, renal failure, urinary retention

Other rarely observed reactions (reported from postmarketing experience in patients taking TORADOL (ketorolac tromethamine) or other NSAIDs) are:

Body as a Whole: angioedema, death, hypersensitivity reactions such as anaphylaxis, anaphylactoid reaction, laryngeal edema, tongue edema (see WARNINGS), myalgia

Cardiovascular: arrhythmia, bradycardia, chest pain, flushing, hypotension, myocardial infarction, vasculitis

Dermatologic: exfoliative dermatitis, erythema multiforme, Lyell’s syndrome, bullous reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis

Gastrointestinal: acute pancreatitis, liver failure, ulcerative stomatitis, exacerbation of inflammatory bowel disease (ulcerative colitis, Crohn’s disease)

Hemic and Lymphatic: agranulocytosis, aplastic anemia, hemolytic anemia, lymphadenopathy, pancytopenia, postoperative wound hemorrhage (rarely requiring blood transfusion – see BOXED WARNING, WARNINGS, and PRECAUTIONS)

Metabolic and Nutritional: hyperglycemia, hyperkalemia, hyponatremia

Nervous System: aseptic meningitis, convulsions, coma, psychosis

Respiratory: bronchospasm, respiratory depression, pneumonia

Special Senses: conjunctivitis

Urogenital: flank pain with or without hematuria and/or azotemia, hemolytic uremic syndrome

Postmarketing Surveillance Study

A large postmarketing observational, nonrandomized study, involving approximately 10,000 patients receiving ketorolac tromethamineIV/IM, demonstrated that the risk of clinically serious gastrointestinal (GI) bleeding was dose-dependent (see Tables 3A and 3B). This was particularly true in elderly patients who received an average daily dose greater than 60 mg/day of ketorolac tromethamineIV/IM (see Table 3A).

Table 3 Incidence of Clinically Serious GI Bleeding as Related to Age, Total Daily Dose, and History of GI Perforation, Ulcer, Bleeding (PUB) After up to 5 Days of Treatment With Ketorolac TromethamineIV/IMA.

Read the entire FDA prescribing information for Toradol (Ketorolac Tromethamine)

Ketorolac Injection

Ketorolac injection is used for the short-term relief of moderately severe pain in people who are at least 17 years of age. Ketorolac injection should not be used for longer than 5 days, for mild pain, or for pain from chronic (long-term) conditions. You will receive your first doses of ketorolac by intravenous (into a vein) or intramuscular (into a muscle) injection in a hospital or medical office. After that, your doctor may choose to continue your treatment with oral ketorolac. You must stop taking oral ketorolac and using ketorolac injection on the fifth day after you received your first dose of ketorolac injection. Talk to your doctor if you still have pain after 5 days or if your pain is not controlled with this medication. Ketorolac may cause serious side effects.

People who are treated with nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as ketorolac may have a higher risk of having a heart attack or a stroke than people who are not treated with these medications. These events may happen without warning and may cause death. This risk may be higher for people who are treated with NSAIDs for a long time. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke or ‘ministroke;’ and if you have or have ever had high blood pressure. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.

Receiving ketorolac injection increases the risk that you will experience severe or uncontrolled bleeding. Tell your doctor if you have or have ever had a bleeding or clotting problem. Your doctor will probably not give you ketorolac injection.

If you are having surgery, including dental surgery, tell the doctor or dentist that you are using ketorolac injection. If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not use ketorolac injection right before or right after the surgery.

NSAIDs such as ketorolac may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, smoke cigarettes, or drink alcohol while using ketorolac injection. Tell your doctor if you take any of the following medications: anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); aspirin; or oral steroids such as dexamethasone (Decadron, Dexpak), methylprednisolone (Medrol), and prednisone (Deltasone). Do not take aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) while you are using ketorolac. Also tell your doctor if you have or have ever had ulcers, holes, or bleeding in your stomach or intestine, or a disease that causes inflammation of the bowels such as Crohn’s disease (a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever) or ulcerative colitis (a condition which causes swelling and sores in the lining of the colon and rectum). If you experience any of the following symptoms, stop using ketorolac injection and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.

Ketorolac may cause kidney failure. Tell your doctor if you have kidney or liver disease, if you have had severe vomiting or diarrhea or think you may be dehydrated, and if you are taking angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); or diuretics (‘water pills’). If you experience any of the following symptoms, stop using ketorolac injection and call your doctor: unexplained weight gain; swelling of the hands, arms, feet, ankles, or lower legs; confusion; or seizures.

Some people have severe allergic reactions to ketorolac injection. Tell your doctor if you are allergic to ketorolac, aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn), any other medications, or any of the ingredients in ketorolac injection. Also tell your doctor if you have or have ever had asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose). If you experience any of the following symptoms, stop using ketorolac injection and call your doctor right away: rash; fever; peeling or blistering skin; hives; itching; swelling of the eyes, face, throat, tongue, lips; difficulty breathing or swallowing; or hoarseness.

You should not receive ketorolac injection during labor or while you are giving birth.

Do not breast-feed while you are using ketorolac injection.

Tell your doctor if you are 65 years of age or older or if you weigh less than 110 lb (50 kg). Your doctor will need to prescribe a lower dose of medication. If you are an older adult, you should know that ketorolac injection is not as safe as other medications that can be used to treat your condition. Your doctor may choose to prescribe a different medication that is safer for use in older adults.

Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably order certain tests to check your body’s response to ketorolac injection.

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) each time you receive a dose of ketorolac injection . Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) to obtain the Medication Guide.

Ketorolac

Ketorolac is the generic form of the brand-name drug Toradol, which is used to relieve short-term, moderate-to-severe pain in adults. This medication is typically given before or after medical procedures or after surgery.

Toradol is in a group of drugs known as non-steroidal anti-inflammatories (NSAIDs), which work by blocking your body’s production of natural substances that cause inflammation.

This medicine is given in an oral and injection form. It was approved by the Food and Drug Administration (FDA) in 1989.

Toradol Warnings

NSAIDs, such as Toradol, may increase the risk for a heart attack or stroke. Although rare, this risk may be greater if you have heart disease or an increased risk for heart disease. Your risk may also increase with prolonged use.

This medicine may cause rare but serious bleeding from the stomach or intestines. This side effect can occur without warning. Older adults may be at a higher risk for stomach bleeding. You should not use Toradol if you have stomach or intestinal issues.

To reduce your risk of stomach bleeding, take this drug at the lowest effective dose for the shortest duration possible. Do not increase your dose or take it more frequently.

Toradol should not be used right before or right after heart bypass surgery or before any type of surgery. It should not be used during labor/delivery or in patients with severe kidney problems.

Kidney problems can sometimes occur while taking NSAIDs. These issues are more likely to happen if you are dehydrated. You should drink plenty of fluids while taking Toradol and tell your doctor about any signs of dehydration.

You should not take Toradol if you are taking high doses of aspirin or other NSAIDs.

You should tell your doctor about your medical history, especially if you have ever had:

  • Asthma
  • Worsening breathing after taking other NSAIDs
  • Bleeding or clotting problems
  • Blood disorders
  • Heart disease
  • Previous heart attack
  • High blood pressure
  • Liver disease
  • Nasal polyps (growths in the nose)
  • Throat, stomach, or intestinal problems
  • Stroke
  • Swelling of the ankles, feet, or hands

You should not take Toradol for more than five days. If you still have pain after five days, talk with your healthcare provider about other medications. You should not take more than 40 milligrams (mg) of the pill form of Toradol in a 24-hour period.

You should keep all appointments with your doctor while taking Toradol. Your physician will monitor your symptoms carefully and will likely order tests to check your body’s response to the drug.

Pregnancy and Toradol

Toradol should only be used when clearly needed during pregnancy. It is not recommended for use during the first and last trimesters because of the possible negative effects it could pose on an unborn baby. The medication may also interfere with normal labor/delivery.

This drug can pass into breast milk. You should talk with your doctor before taking Toradol, if you are breastfeeding.

NFL and pain: League zeros in on one pain medication

During his second year with the Vikings in 2008, Robison had arthroscopic surgery on his right knee in late-November, yet was back playing less than two weeks later. As a young and still unproven player, he knew he couldn’t afford to stay off the field. So for three games, he said, he took a pregame Toradol shot to ease his discomfort and ensure he could contribute.

Many players request the injection much more frequently.

Former Vikings tight end Jim Kleinsasser, whose 13-year career ended in January, estimates he used Toradol before just about every game he played over his final five seasons.

“I was just getting old, honestly,” Kleinsasser said. “There’s a certain point in your career where you’re going through the pounding of the season and getting through that week of practice and trying to get to that next game day. Toradol is part of what gets you back to playing the way you normally can.”

And sometimes that injection can make all the difference. Former NFL star Torry Holt said he only took Toradol a handful of times throughout his 12-season NFL career. His first use came on the afternoon of the Super Bowl in 2000.

Holt was a rookie with the Rams and had separated the acromioclavicular (AC) joint in his right shoulder during St. Louis’ NFC Championship Game win. It was the kind of injury, coupled with bruised ribs, that caused pain so severe that Holt admitted he would have considered sitting out several regular-season games.

But the Super Bowl? With little hesitance, Holt asked for and received a Toradol shot.

Several hours later, after making seven catches for 109 yards, including a 9-yard touchdown grab, Holt was also a Super Bowl champion with the Rams edging the Titans 23-16.

Everything about the day felt great. Until the Toradol faded.

“It was very, very, very painful once that medication wore off,” Holt said. “When you get that Toradol shot, you feel like you have a whole new body on you. At the same time, you’re just tearing away at the problem you have. Masking the pain allows you to get through the game. But the pain is still there, and you’ll have to deal with it afterwards.”

Veterans first

Exact data on the prevalence of Toradol use in the NFL is unavailable, protected by medical confidentiality laws. The Star Tribune interviewed 18 current and former players for this story, and the consensus estimate is that at least 10 players per team per game will receive a Toradol shot before taking the field. That number, players say, can swell toward two dozen players, depending on the time of the season, the age dynamics of the roster and the team’s overall health.

Veterans are more likely to need the shot. And often, younger players are even dissuaded from treating their aches and pains with the injection.

Former fullback Tony Richardson said he used Toradol on a weekly basis in-season for his final seven or eight years in the league. That included stints with the Chiefs, Vikings and Jets.

Dr. Lawrence Brown, the NFL drug program’s administrator, contends it is difficult to make a blanket statement on how much Toradol use is too much, a medical assessment Brown said should be made on a patient-by-patient basis.

That deflects much of the responsibility toward team physicians and the players themselves. And players, often not knowing any better, will frequently steer toward the treatment that gets them back on the field as quickly and pain-free as possible.

Former Vikings Chris Walsh and Sean Berton were among 12 former players filing a lawsuit against the NFL last December. In that suit, Toradol is prominently mentioned, with the plaintiffs alleging the drug may have prevented them from feeling concussions they suffered while playing.

“Ask the NFL, ask their lawyers: before these players were given these drugs, were they taken into a room and given a sheet of paper to read what these drugs might do to them and then given the opportunity to say yes or no?” said former Pro Bowl receiver Joe Horn, one of the 12 players involved in the suit. “If their answer is, ‘No, we did not,’ then guess what, you are at fault. Simple as that.”

Vikings medical personnel say they have taken a proactive approach to educating players on Toradol’s benefits and harms. At training camp every summer, head athletic trainer Eric Sugarman delivers a presentation on the drug.

In order to receive a Toradol injection before a game, Vikings players must first receive approval from a team physician. Vikings players are also required to sign a waiver once per season, acknowledging they understand the risks.

Said Sugarman: “We have never told a player of ours he has to use Toradol. Never. Absolutely not. Now if a guy elects to use Toradol for whatever reason, he has to have informed consent.”

Education needed

Ketorolac (oral/injection)

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

Medically reviewed by Drugs.com on Nov 11, 2019 – Written by Cerner Multum

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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.

Important Information

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 ketorolac 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.

Before taking this medicine

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:

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

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

  • a heart attack, stroke, or blood clot;

  • 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 ketorolac 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 (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

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);

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

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

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.

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.

Further information

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.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 9.03.

Related questions

  • Is Toradol (ketorolac) considered a narcotic?
  • How long does ketorolac (Toradol) stay in your system?

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More about ketorolac

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  • Ketorolac nasal
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  • Ketorolac Oral, Intravenous, Injection, Intramuscular (Advanced Reading)

Other brands: Toradol, Toradol IV/IM, Sprix

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  • Ketorolac Tromethamine (AHFS Monograph)
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Related treatment guides

  • Pain
  • Postoperative Pain

Ketorolac is used for the short-term relief of moderately severe pain and should not be used for longer than 5 days, for mild pain, or for pain from chronic (long-term) conditions. You will receive your first doses of ketorolac by intravenous (into a vein) or intramuscular (into a muscle) injection in a hospital or medical office. After that, your doctor may choose to continue your treatment with oral ketorolac. You must stop taking oral ketorolac on the fifth day after you received your first ketorolac injection. Talk to your doctor if you still have pain after 5 days or if your pain is not controlled with this medication. Ketorolac may cause serious side effects, especially when taken improperly. Take ketorolac exactly as directed. Do not take more of it or take it more often than prescribed by your doctor.

People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as ketorolac may have a higher risk of having a heart attack or a stroke than people who do not take these medications. These events may happen without warning and may cause death. This risk may be higher for people who take NSAIDs for a long time. Do not take an NSAID such as ketorolac if you have recently had a heart attack, unless directed to do so by your doctor. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke or ‘ministroke;’ if you smoke; and if you have or have ever had high cholesterol, high blood pressure, bleeding or clotting problems, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.

If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ketorolac. If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not take ketorolac right before or right after the surgery.

NSAIDs such as ketorolac may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, or drink large amounts of alcohol while taking ketorolac. Tell your doctor if you take any of the following medications: anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); aspirin; oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); or serotonin norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor XR). Do not take aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) while you are taking ketorolac. Also tell your doctor if you have or have ever had ulcers or bleeding in your stomach or intestines. If you experience any of the following symptoms, stop taking ketorolac and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.

Ketorolac may cause kidney failure. Tell your doctor if you have kidney or liver disease, if you have had severe vomiting or diarrhea or think you may be dehydrated, and if you are taking angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (in Zestoretic), moexipril (Univasc), perindopril (Aceon, in Prestalia), quinapril (Accupril, in Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); or diuretics (‘water pills’). If you experience any of the following symptoms, stop taking ketorolac and call your doctor: swelling of the hands, arms, feet, ankles, or lower legs; unexplained weight gain; confusion; or seizures.

Some people have severe allergic reactions to ketorolac. Tell your doctor if you are allergic to ketorolac, aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn), or any other medications. Also tell your doctor if you have or have ever had asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose). If you experience any of the following symptoms, stop taking ketorolac and call your doctor right away: rash; hives; itching; swelling of the eyes, face, throat, tongue, arms, hands, ankles, or lower legs; difficulty breathing or swallowing; or hoarseness.

Do not breastfeed while you are taking ketorolac.

Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably order certain tests to check your body’s response to ketorolac. Be sure to tell your doctor how you are feeling so that your doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects.

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with ketorolac and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) to obtain the Medication Guide.

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

Medically reviewed by Kaci Durbin, MD Last updated on Jan 21, 2019.

  • Overview
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What is Toradol?

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

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

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

Important information

You should not use Toradol 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, or if you are scheduled to have surgery.

Do not use Toradol if you are in your third trimester of pregnancy or if you are breast-feeding a baby.

You should not use Toradol if you also take pentoxifylline, probenecid, aspirin, or other NSAID drugs (which may include ibuprofen, acetaminophen, naproxen, celecoxib, diclofenac, indomethacin, meloxicam, and others and others).

Toradol 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).

Toradol may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using Toradol, especially in older adults. You should not take this medicine if you already have bleeding in your stomach or intestines.

Do not drink alcohol while taking Toradol. Alcohol can increase the risk of stomach bleeding caused by ketorolac.

Since Toradol 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.

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

More about Toradol (ketorolac)

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  • Drug class: Nonsteroidal anti-inflammatory drugs
  • FDA Alerts (8)
  • Toradol (Ketorolac Injection)
  • Toradol (Ketorolac Tablets)
  • Toradol (Advanced Reading)

Other brands: Sprix

  • Toradol (FDA)
  • … +1 more

Other Formulations

  • Toradol IV/IM
  • Pain
  • Postoperative Pain

How does this medication work? What will it do for me?

Ketorolac belongs to the group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It is used for the short-term treatment (5 to 7 days) of acute pain associated with injuries, dental problems or procedures, and after surgery or giving birth. The injectable form of this medication is used for no longer than 2 days to treat moderate-to-severe pain following surgery. Ketorolac reduces a substance in the body that leads to inflammation and pain.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Injection
Each mL of clear, slightly yellow, sterile solution contains 10 mg of ketorolac tromethamine. Nonmedicinal ingredients: alcohol 10% w/v and sodium chloride in sterile water. The pH is adjusted with sodium hydroxide or hydrochloric acid.

How should I use this medication?

The usual adult dose of ketorolac when taken by mouth is 10 mg every 4 to 6 hours as required for pain. Taking more than 40 mg daily is not recommended. Take this medication with meals or a snack to reduce stomach upset. After you have taken the medication, remain sitting or standing upright for 15 to 30 minutes to further reduce acid from the stomach irritating the throat.

The medication should be used for a maximum of 5 days for treatment of pain after surgery and for a maximum of 7 days when treating pain due to an injury. The lowest dose required to control the pain should be used. Ketorolac usually starts to work within an hour, but for some people, it may take up to a day to start working. If you don’t notice improvement in your pain, contact your doctor. This medication should be used for the shortest time period possible.

Ketorolac is also available for use in the hospital as an injectable medication. The usual recommended dose is 10 mg to 30 mg injected into a muscle for no more than 2 days.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to ketorolac or any ingredients of this medication
  • are allergic to ASA or other anti-inflammatory medications (e.g., ibuprofen, naproxen, diclofenac) or have had allergic symptoms (e.g., runny nose, nasal polyps, asthma, itchy skin rash) caused by these medications
  • are currently taking other NSAIDs (e.g., ibuprofen, naproxen, diclofenac)
  • are in the third trimester of pregnancy
  • are in labour or delivery
  • are breast-feeding
  • are scheduled for surgery in the immediate future or have just had surgery
  • are taking probenecid
  • are taking oxpentifylline
  • have a stomach or intestinal ulcer or a history of recurring ulcers
  • have an inflammatory bowel disease (e.g., ulcerative colitis, Crohn’s disease)
  • have bleeding disorders or bleeding in the brain
  • have just had coronary artery bypass graft (CABG) surgery
  • have severe, uncontrolled heart failure
  • have high levels of potassium in the blood
  • have severely reduced liver function or liver disease
  • have reduced kidney function or are at risk of kidney failure

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • bruising at place of injection
  • burning or pain at place of injection
  • diarrhea
  • dizziness
  • drowsiness
  • fatigue
  • feeling of being generally unwell
  • headache
  • increased skin sensitivity to sunlight
  • indigestion
  • loss of appetite
  • nausea
  • stomach upset
  • vomiting

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • blurred vision
  • confusion
  • fever
  • hearing problems
  • high blood pressure
  • signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
  • signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
  • signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine, painful or difficult urination)
  • signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • skin rash or itching
  • small, red spots on skin
  • swelling of the lower legs, ankles, or feet
  • vomiting or persistent indigestion, nausea, stomach pain, or diarrhea

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • chest pain
  • signs of bleeding in the stomach (e.g., bloody, black, or tarry stools, spitting up of blood, vomiting blood or material that looks like coffee grounds)
  • signs of meningitis not caused by infection (e.g., headache , throbbing, or with stiff neck or back)
  • signs of a severe allergic reaction (e.g., hives; difficulty breathing; swelling of the face, mouth, throat, or tongue)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reactions: If you have had a reaction to acetylsalicylic acid (ASA) or other NSAIDs (e.g., ibuprofen, ketoprofen, diclofenac) that included a runny nose, itchy skin rash, nasal polyps, or shortness of breath and wheezing, you should not take this medication. Get immediate medical attention if you experience symptoms of a severe allergic reaction (e.g., hives, difficulty breathing, wheezing, or swelling of the face, tongue, or throat).

Bladder symptoms: This medication can cause bladder symptoms such as frequent or painful urination and blood in urine. If you develop these symptoms, stop taking this medication and contact your doctor immediately.

Bleeding: Ketorolac may cause the platelets in the blood to not stick together very well. This can make it difficult to stop cuts from bleeding. If you have a condition where your blood does not clot easily, or if you are taking medications to prevent your blood from clotting, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.

Blood pressure: Like other NSAIDs, ketorolac can cause increased blood pressure, which may contribute to other heart conditions. If you have high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness and dizziness: This medication can cause drowsiness or dizziness. Do not drive or operate machinery until you are sure that this medication does not affect your ability to do these safely.

Fertility: As with other NSAIDs, this medication may make it more difficult for a couple to conceive if the woman is taking ketorolac. Stopping the medication allows the body’s chemistry to return to normal which often resolves this issue.

Heart conditions: This medication can cause fluid retention, which will make symptoms of certain heart conditions worse. If you have heart failure, high blood pressure, or other medical conditions that increase your risk of fluid retention (e.g., kidney problems), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Heart problems: Like other NSAID medications, ketorolac may increase the risk of heart attacks, strokes, and blood clots. If you have any risk factors for heart problems, such as high blood pressure, high cholesterol, diabetes, peripheral arterial disease, heart failure, or coronary artery disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Infection: This medication may mask signs of infection such as fever or muscle aches. If you notice other symptoms of infection (e.g., painful or frequent urination, sore throat, cough), contact your doctor.

Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. This medication can also affect kidney function. You have a higher risk of developing kidney problems if you are a senior, take diuretics (water pills; e.g., hydrochlorothiazide, furosemide), or already have kidney disease, liver disease, or heart failure. Your doctor may monitor your kidney function with blood tests if you take this medication.

Liver function: This medication may affect your liver function or cause liver problems. If you experience symptoms of liver problems (e.g., nausea, vomiting, feeling tired, yellowing of the skin or eyes), contact your doctor immediately. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severely reduced liver function or have active liver disease should not take this medication.

Long-term use: Long-term use of ketorolac (beyond 5 to 7 days for the tablets, or 2 days for the injection) is not recommended, as the risk of side effects increases with the length of treatment.

Potassium levels: Ketorolac may cause high blood potassium levels. If you are a senior, have diabetes or kidney failure, or are taking beta-blockers (e.g., metoprolol, atenolol), angiotensin converting enzyme (ACE) inhibitors (e.g., ramipril, enalapril), or some diuretics (e.g., triamterene, amiloride), you are more at risk of high blood potassium. Because extremely high blood potassium levels can contribute to other conditions, such as heart problems, your doctor will monitor your potassium level with blood tests while you are taking this medication.

Ulcers and bleeding in the stomach and intestines: This medication may cause stomach ulcers and bleeding from the stomach. These complications can occur at any time and are sometimes severe.

If you have had a stomach or intestinal ulcer, diverticulosis, Crohn’s disease, or ulcerative colitis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms of an ulcer or other stomach problems (e.g., stomach or abdominal pain, black stools, bloody or coffee-ground-like vomit, weakness) contact your doctor immediately or get immediate medical attention.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. It must not be used during the last 3 months of pregnancy as it may cause heart and kidney problems for the developing baby and cause prolonged labour with excessive bleeding during delivery.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking ketorolac, it may affect your baby. Breast-feeding is not recommended while you are taking ketorolac.

Children: The safety and effectiveness of using this medication have not been established for children less than 18 years of age.

Seniors: Seniors have a higher risk of side effects with this medication. If you are a senior, your doctor will closely monitor you for side effects and may prescribe a lower dose than usually recommended.

What other drugs could interact with this medication?

There may be an interaction between ketorolac and any of the following:

  • acetylsalicylic acid (ASA)
  • alcohol
  • aliskiren
  • alteplase
  • aminoglycoside antibiotics (e.g., amikacin, gentamicin, tobramycin)
  • angiotensin converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
  • angiotensin receptor blockers (ARBs; e.g., candasartan, irbesartan, losartan)
  • apixaban
  • beta-blockers (e.g., atenolol, metoprolol)
  • bimatoprost
  • bisphosphonates (e.g., alendronate, etidronate)
  • clopidogrel
  • colesevelam
  • colestipol
  • corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
  • cyclosporine
  • dabigatran
  • dasatinib
  • deferasirox
  • desmopressin
  • digoxin
  • dipyridamole
  • diuretics (water pills; e.g., spironolactone, furosemide, hydrochlorothiazide)
  • edoxaban
  • eplerenone
  • glucosamine
  • haloperidol
  • heparin
  • herbal products that affect blood clotting (e.g., cat’s claw, chamomile, fenugreek, evening primrose, feverfew, garlic, ginger, ginseng, turmeric)
  • hydralazine
  • latanoprost
  • lithium
  • low molecular weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
  • mesalamine
  • methotrexate
  • multivitamins
  • other non-steroidal anti-inflammatory medications (NSAIDs; e.g., naproxen, diclofenac, ibuprofen)
  • omega-3 fatty acids
  • pemetrexed
  • pentoxifylline
  • potassium supplements
  • prasugrel
  • probenecid
  • quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
  • rivaroxaban
  • selective serotonin reuptake inhibitors (SSRIs; e.g., paroxetine, citalopram, escitalopram)
  • serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
  • sodium phosphates
  • sulfasalazine
  • tacrolimus
  • tenofovir
  • ticagrelor
  • ticlopidine
  • tipranavir
  • tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
  • vancomycin
  • vitamin E
  • warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Toradol

What is it used for?

  • Short-term relief of moderate to severe pain following surgery.

How does it work?

Toradol injection contains the active ingredient ketorolac, which is a type of medicine called a non-steroidal anti-inflammatory drug (NSAID).

Ketorolac works by blocking the action of a substance in the body called cyclo-oxygenase (COX). Cyclo-oxygenase is involved in producing prostaglandins, in response to injury or certain diseases, such as arthritis. These prostaglandins cause pain, swelling and inflammation. Ketorolac blocks the production of these prostaglandins and so is effective at relieving pain and inflammation.

Ketorolac is used for the short-term relief of moderate to severe pain following surgical operations.

How is it given?

  • Ketorolac injection may be given either into a muscle (intramuscularly) or into a vein (intravenously).
  • Immediately after the surgery the medicine may be given every two hours if needed. It can then be given every four to six hours as needed for up to two days.
  • Pain relief may not occur until 30 minutes after the injection is given.

Warning!

  • If you have heart failure or kidney disease or you are taking diuretic medicines, your kidney function should be assessed before starting and regularly throughout treatment with this medicine.
  • Your doctor will prescribe you the lowest effective dose of this medicine for the shortest possible time necessary to relieve your symptoms. This is to minimise the chances of any side effects, particularly those mentioned below. It is important not to exceed the prescribed dose.
  • NSAIDs can occasionally cause serious side effects on the gut, such as ulceration, bleeding or perforation of the stomach or intestinal lining. This type of side effect is more likely to occur in elderly people and in people taking high doses of the medicine. The risk can also be increased by taking certain other medicines (see below). It is important that these people, as well as people with a history of disorders affecting the stomach or intestines, are closely monitored by a doctor while having this medicine. If your doctor thinks you are at high risk of side effects on the gut you may be prescribed an additional medicine to help protect your gut. All people having treatment with this medicine should tell the medical staff immediately if they experience any sign of bleeding from the stomach or intestine, for example vomiting blood and/or passing black/tarry/bloodstained stools.
  • Very rarely, NSAIDS may cause serious blistering or peeling skin reactions (eg Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis). For this reason, you should tell the medical staff if you get a skin rash or sores inside your mouth while having this medicine.
  • This medicine may cause various side effects that could impair your mental or physical ability to safely drive or operate machinery. You should be aware of how you react to this medicine before driving or operating machinery.

Use with caution in

  • Elderly people.
  • Decreased kidney function.
  • Decreased liver function.
  • People with a history of disorders affecting the stomach or intestines.
  • People with inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
  • Heart failure.
  • High blood pressure (hypertension).
  • Heart disease caused by inadequate blood flow to the heart (ischaemic heart disease), eg angina or history of heart attack.
  • Disease of the blood vessels in and around the brain (cerebrovascular disease), eg history of stroke or mini-stroke (TIA).
  • People with poor circulation in the arteries of the legs or feet (peripheral arterial disease).
  • Diabetes.
  • Smokers.
  • People with diseases affecting connective tissue, eg systemic lupus erythematosus (SLE).
  • History of allergies.

Not to be used in

  • People in whom aspirin or other NSAIDs, eg ibuprofen, cause allergic reactions such as asthma attacks, itchy rash (urticaria), nasal inflammation (rhinitis) or swelling of the lips, tongue and throat (angioedema).
  • People with a history of asthma.
  • People with the complete or partial syndrome of nasal polyps, angioedema and bronchospasm.
  • People with an active peptic ulcer.
  • People with a history of ulceration, perforation or bleeding in the gut.
  • People with severe heart failure.
  • People with severe liver failure.
  • People with moderate to severely decreased kidney function or kidney failure.
  • People with a low level of fluid in their blood or dehydration, for example due to excessive fluid or blood loss during surgery, severe diarrhoea or vomiting, or treatment with diuretic medicines.
  • People with known or suspected bleeding in the brain.
  • People who have had surgery with a high risk of bleeding or incomplete blood clotting.
  • People with blood clotting disorders.
  • People taking anticoagulant medicines to prevent blood clots, such as heparin, warfarin or dabigatran.
  • Pregnancy, including labour and delivery.
  • Breastfeeding.
  • Hereditary blood disorders called porphyrias.
  • This medicine is not licensed for children under 16 years of age.

This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • The safety of this medicine during pregnancy has not been established. For this reason it should not be used during pregnancy, including during labour and delivery. If used in the third trimester of pregnancy it may delay labour, increase the length of labour and cause complications in the newborn baby. Some evidence suggests that NSAIDs such as this one should also be avoided by women attempting to conceive, as they may temporarily reduce female fertility during treatment and may also increase the risk of miscarriage or malformations. Seek further medical advice from your doctor.
  • This medicine may pass into breast milk in small amounts. The manufacturer states that it should not be used in breastfeeding mothers. Seek further medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

  • Disturbances of the gut, such as diarrhoea, constipation, indigestion, nausea, vomiting or abdominal pain.
  • Excess gas in the stomach and intestines (flatulence).
  • Dry mouth.
  • Loss of appetite.
  • Ulceration or bleeding in the stomach or intestines (see warning section above).
  • Inflammation of the stomach (gastritis) or pancreas (pancreatitis).
  • Increased bleeding time for wounds.
  • Drowsiness.
  • Difficulty concentrating.
  • Anxiety.
  • Depression.
  • Difficulty sleeping (insomnia).
  • Hallucinations.
  • Headache.
  • Dizziness.
  • Spinning sensation (vertigo).
  • Visual disturbances.
  • Shortness of breath.
  • Skin reactions, such as itching, nettle rash.
  • Excessive fluid retention in the body tissues, resulting in swelling (oedema).
  • High blood pressure (hypertension).
  • Slow heartbeat or awareness of your heartbeat (palpitations).
  • Flushing.
  • Allergic reactions such as severe skin rashes, swelling of the lips, tongue and throat (angioedema) or narrowing of the airways (bronchospasm).
  • Kidney, liver or blood disorders.

The side effects listed above may not include all of the side effects reported by the medicine’s manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you are given this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while being treated with this one, to make sure that the combination is safe.

This medicine should not be used in combination with any of the following medicines:

  • anticoagulants eg warfarin, heparin, dabigatran
  • aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs), eg ibuprofen, diclofenac, naproxen
  • lithium
  • oxypentifylline
  • probenecid
  • selective inhibitors of COX-2 such as celecoxib or etoricoxib.

Ketorolac may alter the effect of mifepristone, a medicine used to terminate a pregnancy. This medicine should not be used within 8-12 days of taking mifepristone.

There may be an increased risk of ulceration or bleeding from the gut if ketorolac is used in combination with corticosteroids such as prednisolone.

There may also be an increased risk of bleeding from the gut if ketorolac is used with the following medicines:

  • anti-blood-clotting (anticoagulant) medicines such as warfarin
  • anti-platelet medicines to reduce the risk of blood clots or ‘thin the blood’, eg low-dose aspirin, clopidogrel, dipyridamole
  • selective serotonin re-uptake inhibitors antidepressants, eg fluoxetine, paroxetine, citalopram
  • venlafaxine.

There may be an increased risk of side effects on the kidneys if ketorolac is used with any of the following medicines:

  • ACE inhibitors, eg enalapril
  • angiotensin II receptor antagonists, eg losartan
  • ciclosporin
  • diuretics, eg furosemide
  • tacrolimus.

Ketorolac may oppose the blood pressure lowering effects of certain medicines to treat high blood pressure, such as the following:

  • ACE inhibitors, such as captopril
  • angiotensin II receptor antagonists, such as losartan
  • beta-blockers, such as propranolol
  • diuretics, such as furosemide.

Ketorolac may increase the blood level of methotrexate.

Other medicines containing the same active ingredient

  • Acular eye drops.

Ketorolac injection is also available without a brand name, ie as the generic medicine.

Last updated 07.05.2013

Mar-Ketorolac

Tablet
Each white, round, coated, biconvex tablet debossed with “10” on one side and plain on the other contains 10 mg of ketorolac tromethamine: Nonmedicinal ingredients: microcrystalline cellulose, lactose monohydrate, magnesium stearate, hydroxy-propyl- methylcellulose, titanium dioxide, polyethylene glycol.

There may be an interaction between ketorolac and any of the following:

  • acetylsalicylic acid (ASA)
  • alcohol
  • aliskiren
  • alteplase
  • aminoglycoside antibiotics (e.g., amikacin, gentamicin, tobramycin)
  • angiotensin converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
  • angiotensin receptor blockers (ARBs; e.g., candasartan, irbesartan, losartan)
  • apixaban
  • beta-blockers (e.g., atenolol, metoprolol)
  • bimatoprost
  • bisphosphonates (e.g., alendronate, etidronate)
  • clopidogrel
  • colesevelam
  • colestipol
  • corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
  • cyclosporine
  • dabigatran
  • dasatinib
  • deferasirox
  • desmopressin
  • digoxin
  • dipyridamole
  • diuretics (water pills; e.g., spironolactone, furosemide, hydrochlorothiazide)
  • edoxaban
  • eplerenone
  • glucosamine
  • haloperidol
  • heparin
  • herbal products that affect blood clotting (e.g., cat’s claw, chamomile, fenugreek, evening primrose, feverfew, garlic, ginger, ginseng, turmeric)
  • hydralazine
  • latanoprost
  • lithium
  • low molecular weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
  • mesalamine
  • methotrexate
  • multivitamins
  • other non-steroidal anti-inflammatory medications (NSAIDs; e.g., naproxen, diclofenac, ibuprofen)
  • omega-3 fatty acids
  • pemetrexed
  • pentoxifylline
  • potassium supplements
  • prasugrel
  • probenecid
  • quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
  • rivaroxaban
  • selective serotonin reuptake inhibitors (SSRIs; e.g., paroxetine, citalopram, escitalopram)
  • serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
  • sodium phosphates
  • sulfasalazine
  • tacrolimus
  • tenofovir
  • ticagrelor
  • ticlopidine
  • tipranavir
  • tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
  • vancomycin
  • vitamin E
  • warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Mar-Ketorolac

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