Generic Name and Formulations:
Ketorolac tromethamine 10mg; tabs.
Various generic manufacturers
Short-term management of moderately severe, acute pain requiring opioid-level analgesia.
Use tabs only as continuation therapy to inj. Do not exceed 5 days' combined (inj + tabs) therapy or recommended dose (may use as-needed opioids for breakthrough pain if appropriate). After inj therapy: 17–64yrs (normal renal function): 20mg once then 10mg every 4–6 hours; max 40mg/day. ≥65yrs, or <110lbs, or renal impairment: 10mg once then 10mg every 4–6 hours; max 40mg/day.
<17yrs: not established.
Aspirin allergy. Peptic ulcer. GI bleed or perforation. As prophylactic analgesic before any major surgery. Treatment of peri-op pain in CABG setting. Advanced renal impairment. Hypovolemia. Cerebrovascular bleeding. Hemorrhagic diathesis. Incomplete hemostasis. Bleeding disorders or high risk of bleeding. Concomitant probenecid, salicylates, pentoxifylline, other NSAIDs. Labor & delivery.
Increased risk of serious cardiovascular events, MI, and stroke. Risk of serious GI events. Inflammatory bowel disease. Coagulation disorders. Avoid in peri-op use. Caution with post-op use when hemostasis is critical. Renal or hepatic dysfunction. Discontinue if abnormal liver function tests occur. Correct hypovolemia first. Hypertension (monitor). Cardiac decompensation. May prolong bleeding time. Asthma. Elderly. Debilitated. Pregnancy (Cat.C; avoid in late pregnancy). Nursing mothers.
See Contraindications. Monitor anticoagulants closely. Antagonizes furosemide, possibly antiepileptics. May increase serum lithium, methotrexate levels. ACEIs, diuretics increase renal toxicity risk. Hallucinations with fluoxetine, thiothixene, alprazolam. Apnea with non-depolarizing muscle relaxants. Caution with concomitant SSRIs; may increase GI bleeding risk.
Headache, abdominal pain, dyspepsia, nausea, vomiting, dizziness, drowsiness, edema, hypertension, pruritus, rash, stomatitis, purpura, sweating, peptic ulcer, GI bleed/perforation, bleeding, renal or liver failure, anaphylaxis, skin reactions.
Formerly known under the brand name Toradol.