• Basic Info
• Top Questions
• Clinical Info
• Interactions

What is ketorolac?
Ketorolac is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). 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 other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of ketorolac?

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

Stop taking ketorolac and seek medical attention or call your doctor at once if you have any of these serious side effects:

• chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;

• black, bloody, or tarry stools;

• coughing up blood or vomit that looks like coffee grounds;

• swelling or rapid weight gain;

• urinating less than usual or not at all;

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

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

• pale skin, easy bruising, severe tingling, numbness, pain, muscle weakness; or

• fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions).

Less serious side effects may include:

• upset stomach, nausea, vomiting, diarrhea, constipation;

• mild heartburn, stomach pain, bloating, gas;

• dizziness, headache, drowsiness;

• sweating; or

• ringing in your ears.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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How should I take ketorolac?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label. Ketorolac is not for treating minor aches and pains. Ketorolac is usually given first as an injection, and then as an oral (by mouth) medicine. Ketorolac injection is given through a needle into a muscle or a vein. Your doctor, nurse, or other healthcare provider will give you this injection.

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What is the most important information I should know about ketorolac?
This medicine can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use ketorolac. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG). Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance. This medicine can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking ketorolac. Older adults may have an even greater risk of these serious gastrointestinal side effects.

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What happens if I miss a dose?
Since ketorolac is taken as needed for pain, you may not be on a dosing schedule. And if you receive ketorolac injection in a hospital setting, it is not likely that you will miss a dose. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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What other drugs will affect ketorolac?
Before taking ketorolac, tell your doctor if you are taking any of the following drugs: a blood thinner such as warfarin (Coumadin); lithium (Eskalith, Lithobid); methotrexate (Rheumatrex, Trexall); thiothixene (Navane); alprazolam (Xanax); diuretics (water pills) such as furosemide (Lasix); muscle relaxers; steroids (prednisone and others); seizure medications such as carbamazepine (Carbatrol, Tegretol) or phenytoin (Dilantin); an antidepressant such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), or sertraline (Zoloft);

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Ketorolac has been assigned to pregnancy category C by the FDA. Some animal studies have revealed evidence of teratogenicity. There are no controlled data in humans. In one study, only very small amounts of ketorolac were detected in umbilical vein samples after use in labor and delivery. Ketorolac is only recommended for use during pregnancy when benefit outweighs risk. Ketorolac use is considered contraindicated during labor and delivery since it may adversely affect fetal circulation and inhibit uterine contractions.

Ketorolac is known to cross the placenta. In one study, 32 women received ketorolac 10 mg one time by intramuscular injection to relieve pain during labor. Ketorolac levels were obtained from maternal plasma and from the umbilical cord at the time of delivery, with sample tissues ranging from 0.5 to 6.5 hours post-dose. Ketorolac concentrations ranged from 0.017 to 0.119 mcg/mL in cord blood and from 0.223 to 0.873 mcg/mL in maternal plasma. The mean cord blood to maternal plasma concentration ratio was 0.116. In another study, 18 women were randomly assigned to receive ketorolac 10 mg or meperidine 50 mg or 100 mg one time by intramuscular injection to relieve pain during labor. An analysis of platelet aggregation in whole blood obtained from the neonates revealed a significant inhibition of arachidonic acid- and collagen-induced platelet aggregation in those infants whose mothers received ketorolac. ADP-induced aggregation was not affected. The clinical significance of this finding remains to be determined. Data on the use of ketorolac during pregnancy, other than for the management of labor pain, are lacking.

Ketorolac is excreted into breast milk in small amounts after oral dosing with 10 mg four times daily. Ketorolac is considered compatible with breast-feeding by the The American Academy of Pediatrics. However, the manufacturer considers the use of ketorolac contraindicated in nursing mothers because of the potential adverse effects of prostaglandin-inhibiting drugs on neonates.

The excretion of ketorolac into human milk was evaluated in 10 healthy women. Following oral administration of ketorolac 10 mg four times daily for two days, ketorolac was undetectable (<5 ng/mL) in all milk samples from four patients. In the remaining patients, ketorolac milk concentrations ranged from 5.2 to 7.9 ng/mL 2 hours post-dose. The milk to plasma ratio ranged from 0.015 to 0.037.

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Who should NOT use this medication?

• Peptic ulcer disease, recent GI bleeding or perforation, or history of peptic ulcer disease or GI bleeding.
• Advanced renal impairment or risk of renal failure secondary to volume depletion.
• Labor and delivery.
• Nursing women.
• Known hypersensitivity to ketorolac or any ingredient in the formulation.
• History of asthma, urticaria, or other sensitivity reactions precipitated by aspirin or other NSAIAs.
• Use as a prophylactic analgesic before major surgery; intraoperative use when hemostasis is critical.
• Treatment of perioperative pain in the setting of CABG surgery.
• Suspected or confirmed cerebrovascular bleeding, hemorrhagic diathesis, or incomplete hemostasis; high risk of bleeding.
• Concomitant use with aspirin or NSAIAs.
• Neuraxial (epidural or intrathecal) administration.
• Concomitant use with probenecid.

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, stomach pain, drowsiness, black or bloody stools, coughing up blood, urinating less than usual, shallow breathing, fainting, or coma.

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What should I discuss with my healthcare provider before taking ketorolac?
Do not use this medication if you are allergic to ketorolac, aspirin, or other NSAIDs, or if you have: severe kidney disease; a bleeding or blood clotting disorder; a closed head injury or bleeding in your brain; a stomach ulcer or a history of stomach or intestinal bleeding; or if you are breast-feeding a baby. Do not take ketorolac if you are also taking pentoxifylline (Trental) or probenecid (Benemid). Do not take ketorolac with aspirin or other NSAIDs such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), or piroxicam (Feldene).

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Can I stop taking the medication if I feel better?
If you are taking an analgesic for pain and you are no longer experiencing the pain you may stop using the medication. In general, pain medications are to be used on an as needed basis.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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