Ketorolac (oral/injection)

Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that is used for a short time (5 days or less) to relieve moderate to severe pain.

Ketorolac may also be used for reasons not mentioned in this medication guide.

Follow all instructions on your prescription label and read all medication guides. Use the smallest dose that works for your condition.

Ketorolac oral is taken by mouth.

Ketorolac injection is given as an infusion into a vein. A healthcare provider will administer this injection.

Ketorolac should not be used for more than 5 days, including both injection and tablets. Using ketorolac for a long time can harm your kidneys or cause bleeding.

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

Ketorolac can raise your risk of a deadly heart attack or stroke. Do not use ketorolac just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Ketorolac can also lead to stomach or intestinal bleeding, which can be life-threatening.

You should not use ketorolac if you have any active or recent bleeding (including internal bleeding), 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 for surgery, if you are in late pregnancy, or if you are breast-feeding a baby.

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

Ketorolac can increase your risk of a fatal heart attack or stroke, even if you do not have any risk factors. 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 issues can happen 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.

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.

If you are pregnant, you should not take ketorolac unless your doctor tells you to. Taking an NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy.

Tell your doctor if you are breastfeeding.

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

Get emergency medical help if you have signs of an allergic reaction (hives, difficulty 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.

Ketorolac may cause serious side effects. Stop using ketorolac and call your doctor at once if you have:

• shortness of breath (even with mild exertion);
• swelling or rapid weight gain;
• a 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--loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• kidney problems--little or no urination, swelling in your feet or ankles, feeling tired or short of breath;
• low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.

Common side effects of ketorolac 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.

Since ketorolac is used for pain, you are unlikely to miss a dose. If you do miss a dose and it is almost time for your next dose, skip the missed dose. Do not take two doses at the same time.

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

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

• Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to ketorolac (such as aspirin, ibuprofen, ketoprofen, or naproxen).

Ask your doctor before using ketorolac if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all your other medicines, 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 affect ketorolac, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.