Ketorolac (Toradol): Uses, Dosage, Side Effects, Interactions & Safety
GET HELP TODAY!
100% Confidentiality Guaranteed
Ketorolac Overview at a Glance
What type of medication is ketorolac?
What type of medication is ketorolac: It’s a nonsteroidal anti-inflammatory drug (NSAID) analgesic used for short-term pain relief.
What is ketorolac used for?
What is ketorolac used for: To treat moderate to severe acute pain, usually after surgery or injury.
How long can I take ketorolac?
How long can I take ketorolac: No more than 5 days total across all forms (IV, IM, oral, or nasal spray).
What are the typical doses?
What are the typical doses: IV/IM: 15–30 mg every 6 hours; Oral: 10 mg every 4–6 hours (max 40 mg/day); Nasal (Sprix): 15.75–31.5 mg every 6–8 hours.
What are the most common side effects?
What are the most common side effects: Drowsiness, nausea, headache, and stomach upset.
What serious risks should I know?
What serious risks should I know: GI bleeding/ulcers, kidney problems, and cardiovascular events such as heart attack or stroke.
Who should not take ketorolac?
Who should not take ketorolac: People with active ulcers/GI bleeding, advanced kidney disease, aspirin-sensitive asthma, those undergoing CABG surgery, or pregnant women in late pregnancy.
What drugs interact with ketorolac?
What drugs interact with ketorolac: Other NSAIDs, aspirin, anticoagulants, SSRIs/SNRIs, ACE inhibitors/ARBs, diuretics, lithium, methotrexate, cyclosporine, and digoxin.
Ketorolac—also known as ketorolac tromethamine and sold under brand names like Toradol (injection/tablet) and Sprix (nasal spray)—is a prescription NSAID analgesic used for short‑term relief of moderate to moderately severe acute pain, most often after surgery or injury. It is not an opioid and is not habit‑forming, but it does carry important boxed warnings for gastrointestinal (GI), kidney, and cardiovascular (CV) risks. Critically, treatment must not exceed 5 days in adults, across all routes combined. Mayo Clinic+2MedlinePlus+2
Bottom line up front: Ketorolac can be very effective for short‑term pain after procedures, but safety depends on using the correct route, dose, and duration—and avoiding dangerous drug combinations. If you’re older, under 110 lbs (50 kg), or have kidney issues, your dose should be lower.
What ketorolac is (and isn’t)
Ketorolac reduces pain by blocking COX‑1/COX‑2, lowering prostaglandins that drive inflammation and pain. It’s often used instead of or in addition to opioids in the immediate postoperative period because it can spare opioids—allowing lower opioid doses and fewer opioid side effects. It is not a narcotic and does not treat chronic pain conditions.
Common scenarios: pain after orthopedic procedures, abdominal surgery, dental surgery, or emergency‑department treatment of acute pain. (Some clinicians use it off‑label for migraine or dental pain, but that’s outside FDA labeling.)
Who ketorolac is for—and who should avoid it
Appropriate use: Adults who need short‑term, opioid‑level analgesia following surgery or an acute injury. Therapy typically starts with IV or IM dosing in a monitored setting; oral ketorolac may be used only as continuation if necessary. Sprix provides a non‑injection option for certain adults.
Do not use if any of the following apply:
Active peptic ulcer disease, recent GI bleed or perforation, or a history of NSAID‑related ulcers/bleeding.
CABG surgery context (perioperative pain).
Advanced renal impairment or volume depletion.
Labor and delivery (contraindicated—can affect fetal circulation/uterine contractions).
Aspirin‑sensitive asthma or serious hypersensitivity to ketorolac/NSAIDs.
Concurrent aspirin or other NSAIDs (cumulative risk).
MedlinePlus also notes ketorolac injection is used in people ≥17 years and stresses the 5‑day maximum.
Dosing & administration (all routes)
Never exceed 5 days total (all forms combined). Dose reductions are required in older adults (≥65), <50 kg body weight, and renal impairment.
V / IM (injection)
Typical adult dosing (single dose):
IM: 60 mg once (if <65 years, ≥50 kg, normal renal function); 30 mg once (if ≥65 years, <50 kg, or renal impairment).
IV: 30 mg once (if <65 years, ≥50 kg, normal renal function); 15 mg once (if ≥65 years, <50 kg, or renal impairment).
Multiple‑dose treatment:
<65 years, ≥50 kg: 30 mg IV/IM every 6 hours as needed (max 120 mg/day) for the injectable portion.
≥65 years or <50 kg or renal impairment: 15 mg IV/IM q6h (max 60 mg/day).
Oral tablets (10 mg) — continuation only
Not for initial dose. Start with IV/IM first; transition to oral only if needed.
Typical regimen: 10 mg once after the last injection then 10 mg every 4–6 hours as needed; maximum 40 mg/day.
Counts toward the 5‑day limit.
Intranasal spray (Sprix)
Strength: 15.75 mg per spray; 8 sprays per bottle; discard within 24 hours of first use.
<65 years, ≥50 kg, normal renal function: 31.5 mg (1 spray in each nostril) every 6–8 hours; max 126 mg/day.
≥65 years or <50 kg or renal impairment: 15.75 mg (1 spray in one nostril) every 6–8 hours; max 63 mg/day.
Ophthalmic ketorolac (eye drops)
This page focuses on systemic pain use, but you may see ketorolac as eye drops (e.g., Acular) for ocular inflammation/pain. Doses and risks differ; follow ophthalmic‑specific guidance.
How long can you take ketorolac?
For adults, no more than 5 days total—regardless of route—due to higher risks of GI bleeding, kidney injury, and cardiovascular events with longer exposure.
Missed dose & overdose
Missed dose (oral/nasal): If you’re close to the next dose, skip the missed one—never double up.
Overdose / serious symptoms (severe stomach pain, black stools, vomiting blood, fainting, trouble breathing): seek emergency care or call Poison Control immediately. (The FDA and MedlinePlus detail life‑threatening GI and renal risks.)
Side effects
Common (often mild/transient)
Nausea, dyspepsia, abdominal pain
Dizziness, drowsiness (avoid driving/heavy machinery until you know your reaction)
Headache
Edema (swelling), increased blood pressure
Serious—stop and get medical help
GI bleeding or ulcer: black tarry stools, vomiting blood/coffee‑ground material, severe persistent stomach pain.
Kidney problems: reduced urination, sudden weight gain or swelling of legs/feet, fatigue.
Cardiovascular events: chest pain, shortness of breath, unilateral weakness/slurred speech.
Severe skin/allergic reactions: hives, wheeze, facial swelling, blistering rash.
Bleeding concerns: unusual bruising; nosebleeds; bleeding that won’t stop.
More Time. More Joy. More You. Start Now.
WE ACCEPT MOST INSURANCES
Warnings & contraindications (what makes ketorolac risky)
Gastrointestinal risk
All NSAIDs—including ketorolac—can cause ulcers, bleeding, or perforation of the stomach or intestine. This can occur without warning and may be fatal. Risk rises with age, history of ulcers or GI bleed, concurrent alcohol use, and longer duration.
Cardiovascular risk
NSAIDs may increase the risk of heart attack and stroke, which can be fatal. Risk may increase with duration and in people with cardiovascular disease or risk factors. Do not use for pain in the setting of CABG surgery.
Bleeding / platelet inhibition
Ketorolac inhibits platelet function, increasing bleeding risk—especially with anticoagulants/antiplatelets. Avoid when bleeding risk is high or hemostasis is incomplete.
Renal (kidney) risk
Ketorolac is contraindicated in advanced renal impairment or when volume depleted. Dose reduction is required for renal impairment, older adults, and low body weight.
Pregnancy & breastfeeding
The FDA recommends avoiding systemic NSAIDs at 20 weeks or later in pregnancy due to fetal kidney problems and low amniotic fluid; they’re contraindicated in labor and delivery. Discuss risks and alternatives with your clinician. Breastfeeding considerations are individualized.
Hypersensitivity & asthma
Do not use if you’ve had asthma, urticaria, or allergic‑type reactions after aspirin or other NSAIDs. Severe, potentially fatal anaphylaxis/bronchospasm can occur.
Drug interactions (what not to mix with ketorolac)
Rule #1: Do not combine ketorolac with other NSAIDs or daily aspirin for pain. This greatly raises GI/renal risk without better pain control. Check labels on OTC products (ibuprofen, naproxen).
High‑concern interactions (groups & examples):
Anticoagulants / Antiplatelets: warfarin, DOACs (apixaban, rivaroxaban), heparins; clopidogrel, prasugrel, ticagrelor → major bleeding risk. Medscape Reference
SSRIs/SNRIs: sertraline, fluoxetine, duloxetine, venlafaxine → increased GI bleed risk.
ACE inhibitors / ARBs / Diuretics: lisinopril, losartan, HCTZ, furosemide → reduced kidney perfusion; monitor renal function.
Lithium: NSAIDs reduce renal lithium clearance → lithium toxicity; avoid or monitor closely.
Methotrexate: decreased renal clearance → toxicity.
Cyclosporine: additive nephrotoxicity.
Digoxin: potential increased levels; monitor if combined.
Always give your care team a complete medication list, including OTC pain relievers and supplements.
Special populations
Older adults (≥65), low body weight (<50 kg), renal impairment
For any of these groups, reduce the injectable dose to 15 mg IV/IM q6h (maximum 60 mg/day) and reduce intranasal to 15.75 mg q6–8h (max 63 mg/day). If oral continuation is needed, keep 10 mg q4–6h, max 40 mg/day—and still limit total duration to 5 days.
Pregnancy and postpartum
Avoid systemic ketorolac in late pregnancy and during labor/delivery; NSAIDs after 20 weeks can harm the fetus (renal dysfunction, low amniotic fluid). Use postpartum requires individualized risk/benefit discussion (bleeding concerns).
Pediatrics
U.S. labeling does not establish safety for oral ketorolac in pediatric patients. Many consumer resources emphasize use ≥17 years for injection; clinicians may have specific hospital protocols. Always follow pediatric specialist guidance.
Freedom Starts Here. Take Back Your Life Today.
Same-Day Admissions in Austin Available.
Comparisons: ketorolac vs. other pain relievers
Ketorolac vs. ibuprofen/naproxen
Ketorolac and opioids
When used appropriately, ketorolac reduces opioid requirements after surgery (an “opioid‑sparing” effect). This can mean shorter recovery times and fewer opioid side effects.
Practical tips for safer use
Know your limit: Mark your calendar—5 days max from the first dose of any form (injection, oral, or nasal). Drugs.com
Hydrate and eat: Take oral doses with food and stay hydrated (helps reduce GI and renal strain).
No double NSAIDs: Ibuprofen, naproxen, diclofenac, celecoxib, aspirin for pain—all off‑limits while on ketorolac. Read OTC labels.
Alcohol caution: Alcohol + NSAIDs = higher GI bleed risk; avoid or minimize during the course.
Watch for red flags: Black/tarry bowel movements, vomiting blood, severe stomach pain, scant urine, shortness of breath, chest pain—seek urgent care.
Sprix users: Keep track of sprays; discard the bottle 24 hours after first use, even if liquid remains.
Driving: Until you know how you respond (drowsy/dizzy), don’t drive or use machinery.
Friendly reminder: This page is educational and not medical advice. Always follow your prescriber’s directions and your local hospital’s protocols.
Frequently Asked Questions About Ketorolac (Toradol, Sprix, 10 mg Oral & Injection)
Is ketorolac a strong painkiller?
Yes. Ketorolac is considered a potent NSAID pain reliever, often used for short-term relief of moderate to severe pain, especially after surgery.
Is ketorolac the same as Toradol?
Yes. Toradol is the brand name for ketorolac tromethamine, available in injection and oral tablet form.
Is ketorolac as strong as hydrocodone?
Ketorolac can provide pain relief similar to some opioid medications, but it works differently and is not an opioid.
Is ketorolac 10 mg a narcotic?
No. Ketorolac is not a narcotic or opioid. It belongs to the nonsteroidal anti-inflammatory drug (NSAID) class.
How strong a painkiller is Toradol?
Toradol is one of the strongest NSAID analgesics available, often used in hospitals for short-term pain control.
Is Toradol stronger than Tramadol?
In many cases, Toradol provides faster and more potent pain relief than tramadol, but it carries different risks and strict duration limits.
Is Toradol just strong ibuprofen?
While both are NSAIDs, Toradol (ketorolac) is significantly stronger and comes with higher risks, which is why it’s limited to 5 days of use.
Is Toradol a controlled substance?
No. Toradol is not a controlled substance. It requires a prescription but is not classified as addictive.
What is Sprix used for?
Sprix is a nasal spray formulation of ketorolac, prescribed for short-term treatment of moderate to severe acute pain in adults.
Is Sprix an opioid?
No. Sprix (ketorolac nasal spray) is not an opioid—it’s an NSAID, just like injectable or oral ketorolac.
You Can Recover — Let’s Begin
Barbiturate addiction doesn’t define you. At Nova Recovery Center, we support individuals at every stage of the journey. We offer:
Get help today. Reach out now to start your path to healing.