ketorolac
Ketorolac (Toradol) is a prescription non-steroidal anti-inflammatory drug (NSAID). It provides pain relief by blocking certain chemicals in your body that cause pain and inflammation. But ketorolac (Toradol) is meant for short-term use only due to the risk for severe side effects, such as heart attack and stomach ulcers. Typically, ketorolac (Toradol) is first given as an injection in a hospital or clinic setting. After that, you'll likely continue treatment with the oral tablets, which are taken every 4 to 6 hours for a maximum of 5 days. Your care team will help you transition to a safer alternative pain medication as soon as possible.
What is Ketorolac (Toradol)?
What is Ketorolac (Toradol) used for?
- Short-term, moderate to severe pain in adults
How Ketorolac (Toradol) works
Ketorolac (Toradol) is a non-steroidal anti-inflammatory drug (NSAID). It works by blocking proteins (called cyclooxygenase, or COX) in your body that cause inflammation, pain, and swelling.
Drug facts
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Side effects of Ketorolac (Toradol)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
The following side effects occurred in at least 10% of people during clinical studies:
- Stomach pain
- Nausea
- Indigestion
- Headache
Less Common Side Effects
- Constipation
- Diarrhea
- Vomiting
- Itching
- High blood pressure
Ketorolac (Toradol) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Stomach bleeding: feeling faint, vomiting blood, bloody or dark stools, severe stomach pain or discomfort
- Heart attack: chest pain or tightness, pain that radiates up to your shoulder, arm, neck, or jaw
- Stroke: chest pain, trouble breathing, weakness in one part of your body or face, slurred speech
- Heart failure: difficulty breathing, swelling, fast heartbeat
- High blood pressure: headache, shortness of breath, changes in vision, light-headedness, fatigue
- Worsening liver problems or liver failure: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion, dark or brown urine
- Kidney problems: tiredness, dry and itchy skin, low appetite, urinating less than usual, foamy or bloody urine, muscle cramps
- Allergic reactions: hives, rash, blisters, swelling of the lips or tongue, difficulty breathing
- Serious skin reactions: skin reddening, blisters, rash
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The following Ketorolac (Toradol) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Itching, redness, tearing, or other sign of eye irritation not present before use of this medicine or becoming worse during use
redness of the clear part of the eye
sensitivity to light
swelling of the eye
swelling of the eyelids
tearing
throbbing pain
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Stinging or burning of the eye when medicine is applied
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Ketorolac (Toradol)
Pros
- Works well to treat short-term pain
- Available as tablets and as an injection
- Has been shown to work as well as morphine for treating pain due to certain conditions, so might be a good option for people who can't take opioid pain medications
Cons
- Not recommended during pregnancy
- Might not be the best option if you're 65 years or older, or have kidney, heart, liver, or bleeding problems
- Can only use for up to 5 days
Pharmacist tips for Ketorolac (Toradol)
- You should take ketorolac (Toradol) with foodd to lower the risk of stomach irritation.
- Ketorolac (Toradol) can interact with a lot of commonly used medications, such as blood thinners and certain antidepressants. Tell your healthcare professional (HCP) about all of the medications you're taking before starting ketorolac (Toradol). Don't start any medications while taking ketorolac (Toradol) without talking to your HCP or pharmacist first.
- You shouldn't take ketorolac (Toradol) for more than 5 days because doing so raises your risk for severe and potentially life-threatening side effects, such as heart attack and stomach ulcers. Even during your treatment with ketorolac (Toradol), you and your HCP should discuss safer alternative pain medications that you can switch to as soon as possible.
- Avoid drinking alcohol while taking ketorolac (Toradol) because it can raise your risk for stomach bleeds and stomach ulcers.
- There aren't enough strong studies to know for sure whether or not ketorolac (Toradol) is safe for your baby while you're breastfeeding. Limited data shows ketorolac (Toradol) is found in low amounts in breast milk, but this amount doesn't seem to cause any specific side effect in breastfed babies. Talk to your healthcare team about the risks and benefits of taking ketorolac (Toradol) while breastfeeding.
- Store ketorolac (Toradol) up and away from children and pets so they're less likely to reach and accidentally take the medication. If you think your child accidentally took the medication, call a Poison Control Center right away at 1-800-222-1222.
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Common questions about Ketorolac (Toradol)
No, ketorolac (Toradol) isn't a narcotic or controlled substance and it doesn't have a risk of abuse or dependence. But, your pain specialist will still limit the length of ketorolac (Toradol) treatment to a maximum of 5 days because it can cause serious side effects with long-term use. Be sure to discuss these risks with your healthcare team before starting ketorolac (Toradol).
Yes,ketorolac (Toradol) can cause drowsiness, though it's not a common side effects. To be safe, you might want to avoid driving or doing activities that require focus until you know how ketorolac (Toradol) affects you.
The ketorolac (Toradol) tablets are typically taken every 4 to 6 hours. So the effects of ketorolac (Toradol) will likely last up to 6 hours.
You can start to feel pain relief from ketorolac (Toradol) about half an hour after your injection. If you're taking the ketorolac (Toradol) tablets by mouth, it can take a little longer (with peak pain relief within 2 to 3 hours) just because your body needs to break down the medication first.
Ask your healthcare professional (HCP) or pharmacist if you're not sure if you can take a particular over-the-counter pain medication with ketorolac (Toradol). It's generally safe to also take acetaminophen (Tylenol), if you don't have liver problems. Make sure to ask your HCP how much acetaminophen (Tylenol) you can take. But don't take other NSAIDs, like ibuprofen (Advil) or naproxen (Aleve), because they're in the same drug class as ketorolac (Toradol). Taking more than one NSAID can raise your risk for severe side effects, such as heart problems, kidney problems, or bleeds. Make sure to check the manufacturer label carefully to see if a specific product contains an NSAID.
You need to wait until ketorolac (Toradol) is fully out of your system before taking ibuprofen (Advil), or any other NSAID. This can take a little more than a day based on the half-life of ketorolac (Toradol), but it might take longer for certain people. Taking more than one NSAID at a time raises your risk for kidney problems, serious bleeds, or heart problems. Talk with your healthcare team about when it's safe to take other pain medications after finishing your ketorolac (Toradol) course.
Ketorolac (Toradol) can cause constipation as a side effect. lead to bowel habit changes, like constipation or diarrhea. Although NSAIDs like Ketorolac (Toradol) don't slow down the gut like opioid pain relievers, they can still back you up. If you can't have a bowel movement after using ketorolac (Toradol), speak with your healthcare team so they can investigate further.
If you're pregnant and are prescribed ketorolac (Toradol), let your healthcare team know before starting the medication. A study from the CDC showed that babies born to mothers who took NSAIDs in early pregnancy had a higher risk of birth defects (e.g., hole in the stomach, cleft palate), compared to mothers who took acetaminophen (Tylenol). Additionally, the FDA specifically says to avoid NSAIDs in pregnant females who are at least 20 weeks pregnant because it can cause kidney and heart problems to your unborn baby. If you're pregnant or thinking of becoming pregnant, don't use ketorolac (Toradol) until you've talked to your healthcare team first and they specifically told you it was safe to use. They might be able to recommend safer options for your pain.
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Risks and warnings for Ketorolac (Toradol)
Ketorolac (Toradol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Serious bleeds
- Risk factors: Older adults | History of stomach bleeding or bleeding problems | Stomach ulcers | Liver problems | Taking other medications that raise your risk for bleeds | Drinking alcohol | Smoking | Taking ketorolac (Toradol) for longer than 5 days
Ketorolac (Toradol) raises your risk for serious bleeds, including brain bleeds, stomach ulcers (sores), and stomach bleeds. These bleeds can happen at any time, even without warning. If not treated right away, these bleeds can be life-threatening. Your risk is higher if you're taking other medications that can raise your risk for bleeds. To lower your risk of serious bleeds, make sure to take the lowest dose of ketorolac (Toradol) for the shortest amount of time possible. If you're feeling faint, experience headaches, vomiting blood, have bloody or dark stools, or have severe stomach pain or discomfort that doesn't go away while taking ketorolac (Toradol), get medical attention right away.
Heart attack and stroke
- Risk factors: History of heart problems | Taking high doses of ketorolac (Toradol) | Taking ketorolac (Toradol) for longer than 5 days | History of, or planned, heart surgery
Ketorolac (Toradol) can raise your risk of having blood clots, which can cause a heart attack or stroke. Try to take the lowest dose for the shortest time. If you have heart problems, talk to your healthcare professional (HCP) before starting this medication. Don't take ketorolac (Toradol) if you had or will have heart surgery. Call 911 or get help right away if you experience chest pain, shortness of breath, weakness on one side of your body, or trouble speaking or walking.
Kidney damage
- Risk factors: Older adult | History of kidney problems, heart failure, or liver problems | Not enough fluids in the body (dehydration) | Taking medications that can cause kidney problems
Ketorolac (Toradol) can cause kidney problems. Your risk is higher if you have certain factors like older age, certain medical problems like diabetes, or you're taking medications that can cause kidney problems. Your HCP might order lab tests to monitor your kidney health before and during treatment with ketorolac (Toradol). If your kidney health worsens, your HCP might stop your ketorolac (Toradol) treatment. Contact your HCP if you develop any signs or symptoms of kidney failure, including changes in your need to urinate, tiredness, dry and itchy skin, low appetite, and muscle cramps.
Don't take with other NSAIDs
You should avoid taking any other NSAIDs with ketorolac (Toradol) because doing so will raise your risk of serious side effects, such as bleeding, stroke, and kidney problems. Make sure to check all of your medications, including OTC medications, as NSAIDs are often found in combination medications for cold, flu, or headache.
Higher risk of serious side effects
- Risk factors: Age 65 years and older | Having body weight less than 110 lbs | Kidney problems
If you have any of the risk factors listed above, you're at a higher risk for serious side effects, such as bleeding, heart attack, and stroke. Your HCP will prescribe you a lower dose of ketorolac (Toradol) in order to lessen your risk of these side effects. Don't take more ketorolac (Toradol) than what's prescribed for you. Talk with your HCP about switching to another safer pain medication as soon as possible.
High blood pressure and heart failure
- Risk factors: History of heart problems
Ketorolac (Toradol) can cause your body to hold onto extra fluid, which can raise your blood pressure or put you at risk for heart failure. Tell your HCP if you have a history of heart problems or are taking blood pressure medications before starting ketorolac (Toradol) to make sure it's safe for you. Your HCP will screen you for heart problems before starting you on this medication. Some forms of ketorolac (Toradol) contain sodium, so it's important to keep track of how much you're getting from your doses if you're on a low-salt diet. If you experience unexplained fainting, chest pain with physical activity, or irregular heartbeat while taking ketorolac (Toradol), contact your healthcare team.
Liver damage
- Risk factors: History of liver problems
Though rare, ketorolac (Toradol) can cause serious liver problems that can lead to liver failure. Get medical attention right away if you notice swelling of your stomach, stomach pain, yellowing of your skin or the whites of your eyes, clay-colored stools, nausea, vomiting, confusion, or dark or brown urine. You might need to stop using the medication to prevent further liver damage.
Severe allergic reactions
- Risk factors: Aspirin allergy | NSAID allergy | Aspirin-sensitive asthma
Severe allergic reactions to ketorolac (Toradol) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). Let your healthcare team know if you have an allergy to aspirin or other NSAIDs before starting ketorolac (Toradol). If you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using ketorolac (Toradol), get medical attention right away.
Although rare, ketorolac (Toradol) can cause serious skin reactions, such as rash, blisters, skin reddening, or skin peeling. If you notice changes in your skin, stop using ketorolac (Toradol) and get medical attention right away.
Ketorolac (Toradol) dosage
Typical dosage for Ketorolac (Toradol)
Your healthcare professional will determine your dose of ketorolac (Toradol) based on your age, body weight, and whether or not you have kidney problems. The maximum length of time that you'll take ketorolac (Toradol) (injection and oral combined) is 5 days.
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Injection into the veins: The typical dose is 15 mg or 30 mg injected as a single dose, or 15 mg or 30 mg injected every 6 hours as needed by a healthcare professional. The maximum daily dose is 60 mg or 120 mg, depending on your age, weight, and health conditions.
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Injection into the muscle: The typical dose is 30 mg or 60 mg injected as a single dose, or 15 mg or 30 mg injected every 6 hours as needed by a healthcare professional. The maximum daily dose is 60 mg or 120 mg, depending on your age, weight, and health conditions.
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Oral (by mouth): You'll only take ketorolac (Toradol) oral tablets if you've already started ketorolac (Toradol) injections during your hospital stay. The typical dose is 10 mg or 20 mg by mouth as a single dose, followed by 10 mg every 4 to 6 hours as needed. The maximum daily dose is 40 mg.
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Interactions between Ketorolac (Toradol) and other drugs
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Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Aceclofenac
- Acemetacin
- Amtolmetin Guacil
- Aspirin
- Bromfenac
- Bufexamac
- Celecoxib
- Choline Salicylate
- Clonixin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Ibuprofen
- Indomethacin
- Ketoprofen
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Pentoxifylline
- Phenylbutazone
- Piketoprofen
- Piroxicam
- Proglumetacin
- Propyphenazone
- Proquazone
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sodium Salicylate
- Sulfasalazine
- Sulindac
- Tenoxicam
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Valdecoxib
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abciximab
- Acenocoumarol
- Anagrelide
- Apixaban
- Ardeparin
- Argatroban
- Bemiparin
- Betamethasone
- Bivalirudin
- Budesonide
- Cangrelor
- Certoparin
- Cilostazol
- Citalopram
- Clopidogrel
- Cortisone
- Dabigatran Etexilate
- Dalteparin
- Danaparoid
- Deflazacort
- Desirudin
- Desvenlafaxine
- Dexamethasone
- Dipyridamole
- Duloxetine
- Edoxaban
- Enoxaparin
- Epoprostenol
- Eptifibatide
- Escitalopram
- Feverfew
- Fluocortolone
- Fluoxetine
- Fluvoxamine
- Fondaparinux
- Ginkgo
- Heparin
- Hydrocortisone
- Iloprost
- Lepirudin
- Levomilnacipran
- Meadowsweet
- Methotrexate
- Methylprednisolone
- Milnacipran
- Nadroparin
- Nefazodone
- Paramethasone
- Parnaparin
- Paroxetine
- Phenindione
- Phenprocoumon
- Prasugrel
- Prednisolone
- Prednisone
- Protein C
- Reboxetine
- Reviparin
- Rivaroxaban
- Sertraline
- Sibutramine
- Ticagrelor
- Ticlopidine
- Tinzaparin
- Tirofiban
- Treprostinil
- Venlafaxine
- Vilazodone
- Vorapaxar
- Vortioxetine
- Warfarin
How much does Ketorolac (Toradol) cost?
$3.20
Ketorolac (Toradol) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Ketorolac (Toradol) will not be safe for you to take.
- History of or currently have active peptic ulcer disease or stomach bleeds
- History of asthma, hives, or other allergic reactions after taking aspirin or another NSAID
- Use for preventing pain before surgery
- Severe kidney problems or at risk for kidney problems due to dehydration
- Use of ketorolac (Toradol) after coronary artery bypass graft surgery (CABG)
- Use of ketorolac (Toradol) during labor and delivery
- Confirmed, or at high risk for, bleeding
- Taking other NSAIDs, including aspirin
- Taking probenecid
- Taking pentoxifylline
What are alternatives to Ketorolac (Toradol)?
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