Ketorolac (Toradol): Uses, Dosage, Side Effects, Interactions & Safety

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.

Oral tablets (10 mg), continuation only

• Not for initial dose.Start with IV/IM first; transition to oral only if needed.
• Typical regimen10 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)

• Strength15.75 mg per spray; 8 sprays per bottle; discard within 24 hours of first use.
• <65 years, ≥50 kg, normal renal function31.5 mg (1 spray in each nostril) every 6–8 hours; max 126 mg/day.
• ≥65 years or <50 kg or renal impairment15.75 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.)

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).

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.