7 Ketorolac Side Effects You Should Know About

Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that treats pain and swelling. But it’s a bit different from other NSAIDs. Ketorolac is only available with a prescription, and it’s meant to provide short-term relief of moderate-to-severe pain.

Your first dose of ketorolac will likely be given as an injection into your muscle or vein at the hospital or a similar healthcare facility. Then, your healthcare provider will determine if you should continue taking the medication as an oral tablet or nasal spray (Sprix). If so, you’ll likely be told to take ketorolac for no more than 5 days total. This is done to help lower the risks of serious side effects. But even when taken as prescribed, ketorolac can still cause side effects.

Ketorolac side effects at a glance

Ketorolac has a higher risk of certain side effects than other NSAIDs. It’s the reason your provider will limit your prescription to just 5 days, including any doses given by injection. But, even with a short course, side effects are still possible.

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Common ketorolac side effects include:

• Stomach pain

• Nausea and vomiting

• Indigestion

• Headaches

• Heartburn

• Gas

• Constipation

• Diarrhea

• Swelling of the arms or legs

Potentially serious ketorolac side effects include:

• Stomach and intestinal ulcers

• Mouth sores

• A higher risk of bleeding

• Kidney damage

• Raised blood pressure

• Heart problems

• Severe skin reactions

• Birth defects

Below, we detail seven of these ketorolac side effects and discuss strategies to manage them. But, keep in mind, the above lists don’t include all of the possible side effects of the medication.

1. Stomach-related side effects

Some of the most common ketorolac side effects are digestive problems. Common examples include stomach pain, indigestion, and nausea. Some people also experience heartburn, constipation, or diarrhea. These side effects happen because ketorolac blocks an enzyme (protein) that helps protect the lining of the stomach and intestines.

To help prevent or lessen stomach problems from ketorolac, always take it with food. Be sure to let your healthcare provider know if you’re unable to eat. They may recommend a different pain medication.

Even though ketorolac prescriptions are only for a few days, don’t ignore stomach symptoms that seem severe. They could be signs of a more serious problem, such as stomach ulcers.

2. Swelling of the arms or legs

Swelling, especially in the legs and ankles, is common with NSAIDs such as ketorolac. This is typically due to fluid retention. And it should resolve on its own once you stop taking the medication.

While swelling is usually mild and short-lived with ketorolac, this isn’t always true. NSAIDs can worsen heart failure, which can lead to swelling. So it’s typically recommended to avoid ketorolac and other NSAIDs if you have heart failure.

3. Stomach or intestinal ulcers

As mentioned earlier, ketorolac can irritate your digestive tract. In severe cases, this irritation can lead to ulcers, bleeding, or holes in your stomach and intestines. All NSAIDs can cause this side effect, but the risk is highest with ketorolac.

To minimize this risk, don’t take more ketorolac than recommended or take it for longer than 5 days. It’s also important to tell your healthcare provider about any health conditions you have. Some conditions can raise your risk of serious stomach problems related to ketorolac.

People with a greater risk of these serious side effects include those:

• Ages 65 years or older

• With a history of peptic ulcer disease

• Who smoke

• Who drink three or more alcoholic drinks per day

• Who take corticosteroids, such as prednisone

• Who take a blood thinner, such as warfarin (Coumadin, Jantoven)

Discuss the above risk factors and how to spot symptoms of intestinal bleeding with your provider. Also, ask your pharmacist about potential interactions with ketorolac. Combining ketorolac with some medications, such as aspirin or certain over-the-counter pain relievers, may raise the risk of stomach ulcers or bleeding.

4. Higher risk of bleeding

Ketorolac may raise your risk of bruising and bleeding, including bleeding after surgery. This is because ketorolac can make it harder for platelets to stick together. Platelets are blood cell fragments that stick together to help form clots and stop bleeding when you’re injured.

This side effect rarely causes problems for people who take ketorolac. But people with bleeding disorders or those taking blood thinners have a higher risk of bleeding both in general and related to the medication. Taking it shortly before surgery can also increase the risk of post-procedure bleeding. So be sure that your healthcare provider knows about any health conditions you have and the medications that you’re taking.

5. Kidney damage

Ketorolac has a greater impact on your kidneys than other NSAIDs. It temporarily decreases blood flow to your kidneys, potentially making it harder for them to work efficiently. Sometimes, this can lead to kidney damage.

Although this side effect sounds scary, it’s rarely a problem for people who have normal kidney function and take ketorolac as prescribed. But if you have existing kidney problems or if you take more ketorolac than directed, you may be at greater risk.

You can help lower your risk for kidney damage by taking ketorolac as directed. That means not taking extra doses or taking it for longer than prescribed. It’s also important to discuss the risks with your healthcare provider if you have a history of kidney problems. They may recommend a different pain medication.

Combining ketorolac with certain medications can also raise your risk for kidney side effects. For instance, common blood pressure medications — like diuretics (“water pills”) and angiotensin-converting enzyme (ACE) inhibitors — can increase the likelihood of kidney problems from ketorolac. Your pharmacist and provider should screen your medication list for potential interactions to help you avoid this.

6. Raised blood pressure

NSAIDs such as ketorolac can raise your blood pressure. Typically, this increase is small and resolves after stopping treatment with the medication. But it can be a problem if you already have high blood pressure (hypertension). It can also make it harder for blood pressure medications to work effectively.

Make sure your healthcare provider knows if you have high blood pressure or take blood pressure medication. They may recommend checking your blood pressure more often while you’re taking ketorolac. They may also prescribe you a different pain reliever.

7. Heart problems

Taking any NSAID, including ketorolac, can raise your risk of heart problems. This includes the risk for heart attack, stroke, and heart failure. In fact, the risk of heart problems is highest with ketorolac when comparing it to other NSAIDs. But even so, the risk of having these complications from ketorolac is rare for many people.

Talk to your healthcare provider about safe pain treatment options if you’re living with heart problems or heart disease. Although anyone can experience heart problems with ketorolac, the risk is higher for people with existing issues.

If you’re taking low-dose aspirin for heart health, ask your provider if it’s safe for you to take ketorolac. Ketorolac can block the benefits of low-dose aspirin. As mentioned above, the combination can also raise your risk of bleeding and stomach ulcers.

When should I contact my healthcare provider about ketorolac side effects?

Common ketorolac side effects, such as stomach pain and swelling, should resolve on their own once you finish taking the medication. But if you have side effects that don’t go away or seem severe, contact your healthcare provider.

Certain symptoms may indicate a serious ketorolac side effect. Seek medical help if you experience any of these symptoms:

• Blood in your stool or vomit

• Stools that are black or sticky like tar

• Swelling or fluid retention (if you also have heart failure)

• Feeling more tired or weaker than usual

Call 911 or go to the nearest emergency room if you experience any of the following:

• Chest pain

• Shortness of breath

• Weakness on one side of your body

• Slurring of speech

• Severe headache with vision changes

• Sudden decrease in the amount of urine you make

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Written by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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