Ketorolac Treatment Report

Precautions

Instructions

Side Effects

Interactions

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).

Taking an NSAID can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

NSAIDs 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 an NSAID. Older adults may have an even greater risk of these serious gastrointestinal side effects.

Before taking ketorolac, tell your doctor if you are allergic to any drugs, or if you have:

• a history of heart attack, stroke, or blood clot;
• heart disease, congestive heart failure, high blood pressure;
• liver or kidney disease,
• ulcerative colitis or Crohn's disease;
• asthma;
• polyps in your nose;
• if you have recently had surgery; or
• if you smoke.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take ketorolac.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Taking ketorolac during labor can increase the risk of bleeding during childbirth. Do not take ketorolac during pregnancy unless your doctor has told you to.

This medication can affect fertility (your ability to have children). Do not take ketorolac while you are trying to get pregnant.

Ketorolac can pass into breast milk and may harm a nursing baby. Do not take this medicine without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to anyone younger than 18 years old.

Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Many medicines available over the counter contain aspirin or other medicines similar to ketorolac (such as ibuprofen, ketoprofen, or naproxen). If you take certain products together you may accidentally take too much of this type of medication. Read the label of any other medicine you are using to see if it contains aspirin, ibuprofen, ketoprofen, or naproxen.

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

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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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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, mild nausea or 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. You may report side effects to FDA at 1-800-FDA-1088.

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Tell your doctor if you are taking an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor). Taking any of these drugs with ketorolac may cause you to bruise or bleed easily.

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);
• a heart or blood pressure medication such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro, Avalide), losartan (Cozaar, Hyzaar), valsartan (Diovan), telmisartan (Micardis), or olmesartan (Benicar); or
• aspirin or other NSAIDs such as etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others; or
• an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), ramipril (Altace), and others.

This list is not complete and there may be other drugs that can interact with ketorolac. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Toradol, Toradol IM, Toradol IV/IM, and ketorolac

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