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All about: ketorolac

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Generic Name: ketorolac (KEE toe ROLE ak)
Brand Names: Toradol

What is ketorolac?

Ketorolac is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Ketorolac works by reducing hormones that cause inflammation and pain in the body.

Ketorolac is used short-term (5 days or less) to treat moderate to severe pain.

Ketorolac may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about ketorolac?

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

Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

This medicine 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 ketorolac. Older adults may have an even greater risk of these serious gastrointestinal side effects.

Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

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.

What should I discuss with my healthcare provider before taking ketorolac?

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.

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.

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,
  • asthma;

  • polyps in your nose;

  • if you have recently had surgery; or

  • if you smoke.

If you have any of these conditions, you may not be able to use ketorolac, or you may need a dosage adjustment or special tests during treatment.

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.

How should I take ketorolac?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label. Ketorolac is not for treating minor aches and pains.

Ketorolac is usually given first as an injection, and then as an oral (by mouth) medicine. Ketorolac injection is given through a needle into a muscle or a vein. Your doctor, nurse, or other healthcare provider will give you this injection.

The ketorolac tablet should be taken with a full glass of water. Ketorolac is normally given for 5 days or less, including both the injection and oral forms combined. Long-term use of ketorolac can damage your kidneys or cause bleeding. If you need to have any type of surgery, tell the surgeon ahead of time if you have recently used ketorolac. Store ketorolac tablets at room temperature away from moisture and heat.

What happens if I miss a dose?

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.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include nausea, vomiting, stomach pain, drowsiness, black or bloody stools, coughing up blood, urinating less than usual, shallow breathing, fainting, or coma.

What should I avoid while taking ketorolac?

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.

Ketorolac side effects

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;

  • 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 include:

  • upset stomach, nausea, vomiting, diarrhea, constipation;

  • mild heartburn, stomach pain, bloating, gas;

  • dizziness, headache, drowsiness;

  • skin itching or rash;

  • sweating; or

  • ringing in your ears.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect ketorolac?

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);

  • diuretics (water pills) such as furosemide (Lasix);

  • seizure medications such as carbamazepine (Carbatrol, Tegretol) or phenytoin (Dilantin);

  • medicine for depression or mental illness;

  • muscle relaxers;

  • steroids (prednisone and others); or

  • an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), ramipril (Altace), and others.

If you are using any of these drugs, you may not be able to use ketorolac or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect 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.

Where can I get more information?

  • Your pharmacist has information about ketorolac written for health professionals that you may read.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 6.05. Revision Date: 07/12/2007 7:07:10 PM.

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