Ketorolac (Nasal)

Ketorolac is a pain medication that reduces inflammation as well as pain. It is usually prescribed as an analgesic.

Overview

Ketorolac is an anti-inflammatory, nonsteroidal medication that reduces inflammation and pain. This medication is considered to be part of the initial generation of NSAID medications.

As a nasal spray, it relieves moderate to moderately serious pain, similar to the pain that takes place after surgery or similarly uncomfortable procedure.

The initial dose of this medication will likely be given by an injection intravenously (in a vein) or intramuscular (in a muscle) in a hospital or doctor's office. After the initial dose, the physician could decide to continue treating you with a ketorolac by nasal or oral ketorolac.

This medication works by hindering the prostaglandins bodily synthesis.

Ketorolac can potentially have highly dangerous side effects. The likelihood of experiencing a severe side effect can increase with how much medication is used and for how long the medication is taken. It is important that this medication is not consecutively taken for longer than 5 days. Prior to taking this medication, discuss the potential risks and benefits of the ketorolac medication with your physician.

This medication can only be obtained with a valid prescription from your physician. It can only be obtained in the nasal spray form. It is currently being manufactured under the US brands Sprix and Toradol.

Conditions treated

Type of medicine

  • Nonsteroidal anti-inflammatory drug

Side Effects

In addition to positive benefits, medications can occasionally trigger undesired side effects. While typically not every side effect will take place, if you do experience them they could require medical care.

Consult with your physician right away if you experience any of the slide effects on the following lists:

More Common Side Effects (Medical Care Required)

  • Weakness or tiredness (unusual)
  • Vomiting of material similar in appearance to coffee grounds or blood
  • Sweating
  • Stomach pain (severe)
  • Stomach or abdominal burning, cramping, or general pain
  • Skin paleness
  • Racing, pounding, irregular, or fast pulse or heartbeat
  • Nervousness
  • Nausea
  • Headache
  • Ear pounding
  • Dizziness
  • Bruising or bleeding (unusual)
  • Bloody or tarry, black stools

Less Common Side Effects (Medical Care Required)

  • Shallow or rapid breathing
  • Reduced urine output or frequency
  • Increased frequency of urination
  • Fainting, dizziness, or lightheadedness
  • Difficulty breathing
  • Chest discomfort or pain
  • Burning sensation in the stomach or chest

Rare Side Effects (Medical Care Required)

  • Yellow skin or eyes
  • Weight loss or gain
  • Vomiting
  • Swollen glands
  • Swelling of the lower legs, feet, fingers, or face
  • Swallowing difficulty
  • Stools that are clay-colored
  • Stomach or upper right abdominal pain
  • Side or lower back pain
  • Rash, itching, or hives
  • Painful, burning, or difficult urination
  • Nosebleeds
  • Fatigue (extreme)
  • Dark, cloudy, or bloody urine
  • Confusion
  • Chest tightness
  • Breath odor that is unpleasant

Additional Side Effects ' Occurrence Rate Unknown (Medical Care Required)

  • Loosening, peeling, or blistering of skin
  • Moving difficulty
  • Speaking difficulty
  • Lightheadedness, faintness, or dizziness when standing quickly from a sitting or lying position
  • Swelling of the body (general)
  • Muscle or joint pain
  • Discomfort or pain in the neck, back, jaw, or arms
  • Pains in the abdomen, side, or stomach; possibly spreading to back
  • Blue or pale skin, fingernails, or lips
  • Swelling or puffiness of eyelids or area around tongue, lips, face, or eyes
  • Itching, soreness, or redness of skin
  • Mental or mood shifts (severe)
  • Sneezing
  • Blisters, welting, or sores
  • Tender, painful, or swollen lymph glands in the groin, armpit, or neck
  • Heaviness or weakness of legs

Certain side effects could take place, but these typically will not require medical care. These specific side effects will likely disappear as your body becomes more accustomed to the medication. In addition, your doctor can likely inform you of additional methods of preventing or reducing some side effects. Consult with your doctor if the side effects listed below become prolonged, bothersome, or if you have concerns or questions regarding them:

More Common Side Effects (Medical Care Not Required)

  • Sour or acid stomach
  • Passing gas
  • Nasal discomfort
  • Inflammation or swelling of the mouth
  • Hearing loss
  • Full feeling
  • Drowsiness
  • Continuous buzzing, ringing, or other kinds of noise that is unexplained in ears
  • Belching

Less Common Side Effects (Medical Care Not Required)

  • Stuffy nose
  • Runny nose
  • Eye watering

Rare Side Effects (Medical Care Not Required)

  • Tingling,'œpins and needles', prickling, numbness, itching, crawling, or burning feelings
  • Spinning sensation
  • Soreness, swelling, or redness of the tongue
  • Shakiness in the feet, hands, arms, or legs
  • Restlessness or irritability
  • Muscle stiffness, jerking, or trembling
  • Movements that are uncontrolled, specifically of the back, neck, or face
  • Feeling, hearing, or seeing things not there
  • Excessive thirst
  • Difficulty sleeping
  • Difficulty concentrating
  • Concentration inability
  • Abnormal taste
  • Abnormal dreams

Additional Side Effects' Occurrence Rate Unknown (Medical Care Not Required)

  • Stiff back or neck
  • Swelling, pain, or redness of the inner eyelid lining, eyelid, or eye
  • Itching, dry, or burning eyes
  • Excessive tearing or eye discharge

Additional side effects not included above could also take place for certain patients. If other side effects are observed, consult with your medical care professional.

Contact your doctor if you are seeking medical advice regarding side effects. The FDA also accepts reports of side effects, and they can be reached by calling 1-800-FDA-1088.

Dosage

Only take this medication as your physician has directed to bring the most benefit to your condition. Never take an amount that is more than the prescribed dose. Do not take this medication more frequently than prescribed. Finally, do not take ketorolac for a duration that is longer than prescribed. This medication should not be taken for more than five consecutive days. The days that the patient takes the medication will also include doses that were given in a clinic or hospital setting. Taking a dose that is greater than the prescribed dose will increase the likelihood of side effects taking place, especially in the case of geriatric patients.

This medication should have a medication summary guide and instructions for the patient included. Follow and read all instructions. Consult with your physician if you have concerns or questions.

Ketorolac nasal spray is intended only for nasal use. Never inhale or breathe in this medication at the same time as spraying. Never get this medication in the eyes. If it does get in your eyes, rinse your eyes with saline or water immediately and contact your physician.

Always ensure you are drinking extra fluids while on ketorolac. This will ensure your kidneys are working as they should and this will aid in the prevention of serious kidney issues.

Usage Instructions:

For first time patients of the ketorolac will need to first prime the spray prior to using it. In order to do so correctly, first pump the bottle five times to make a portion of the medication come out. It is then ready for use.

Blow your nose gently to clear nostrils as much as possible.

Stand or sit up straight to tilt the head in a forward direction.

Put the very tip of the medication bottle into the nostril on the right. Point the direction of the bottle away from the middle of the nose.

While holding your breath, spray one time directly into the right nostril. Breathe in and hold the breath while spraying one time into the nostril on the right side. Breathe in slowly through the mouth. Pinch the nose if desired, doing so will give the medication a chance to be absorbed through shin within nose. '

After the spray has been used, clean the top of the bottle with a tissue (clean) and replace the plastic clear cover of the medication. The bottle should not be used for longer than 24 hours after the initial dose. Dispose of the bottle after the 24-hour period, even if liquid still remains in the bottle.

Different patients will receive a unique dose of this medication. Always follow the instructions given by your physician or the label instructions. The information included here will summarize only typical doses of ketorolac. Patients who were given a dose that varies from the information listed here should not adjust their dose unless instructed to do so by your doctor.

The quantity of medication prescribed will depend on how strong the medication is. In addition, the total quantity of doses taken per day, the allotted time between each dose, and the total duration for which you take this medication will depend directly on the medical issue for which you need ketorolac.

Nasal Spray Dosing Information

For Treatment of Pain

  • Adults (who weigh 50 kg or greater): Take 31.5 mg (milligrams) which equals one spray in both nostrils each period of 6 to 8 hours. Physician may adjust dosage information as required. However, total dose should not exceed 126 mg or greater (8 sprays total) each day.
  • Elderly adults or adults (who weigh less than 50 kg): Take 15.75 mg (milligrams) which equals one spray in just one nostril one time for each 6 to 8 hour period. However, the total dose should not exceed 63 mg (four sprays total) daily.
  • Children: Physician must calculate appropriate dosage information for pediatric patients.

Missed Dose

For missed doses of medications, take it as soon as you get a chance. However, if your scheduled next dose is closer in the dosing schedule, you may wait and miss the skipped dose and return to the original dosage schedule. Never take a double dose of ketorolac.

Interactions

Drug Interactions

While some medications should not ever be taken at the same time, in other circumstances if your physician believes the combination to be beneficial they may prescribe both medications (despite the possibility of interaction). Under these circumstances, your physician may be inclined to adjust your dose, or they may pursue taking other kinds of precautions to protect you as a patient. When taking ketorolac, it is essential that your physician is aware if you are already taking any of the prescription medications on the following list. The interactions listed below were chosen due to their possible significance. These lists are not entirely all-inclusive.

Taking ketorolac with the medications below is not suggested. Your physician may choose not to prescribe ketorolac or they may adjust other medications you may be taking.

  • Valdecoxib
  • Tolmetin
  • Tolfenamic Acid
  • Tiaprofenic Acid
  • Tenoxicam
  • Sulindac
  • Sulfasalazine
  • Sodium Salicylate
  • Salsalate
  • Salicylic Acid
  • Rofecoxib
  • Proquazone
  • Propyphenazone
  • Proglumetacin
  • Probenecid
  • Piroxicam
  • Piketoprofen
  • Phenylbutazone
  • Pentoxifylline
  • Parecoxib
  • Oxyphenbutazone
  • Oxaprozin
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nepafenac
  • Naproxen
  • Nabumetone
  • Morniflumate
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Ketoprofen
  • Indomethacin
  • Ibuprofen
  • Flurbiprofen
  • Flufenamic Acid
  • Floctafenine
  • Feprazone
  • Fepradinol
  • Fenoprofen
  • Felbinac
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Droxicam
  • Dipyrone
  • Diflunisal
  • Diclofenac
  • Dexketoprofen
  • Dexibuprofen
  • Clonixin
  • Choline Salicylate
  • Celecoxib
  • Bufexamac
  • Bromfenac
  • Aspirin
  • Amtolmetin Guacil
  • Acemetacin
  • Aceclofenac

It is not typically suggested to take ketorolac with the following drugs, however some cases could require it. Your physician may adjust the dose or frequency for either one or both medications if they decide to prescribe both medications simultaneously.

  • Xipamide
  • Warfarin
  • Vortioxetine
  • Vorapaxar
  • Vilazodone
  • Venlafaxine
  • Trimipramine
  • Trichlormethiazide
  • Triamterene
  • Treprostinil
  • Torsemide
  • Tirofiban
  • Tinzaparin
  • Ticlopidine
  • Ticagrelor
  • Tianeptine
  • Tacrolimus
  • Spironolactone
  • Sibutramine
  • Sertraline
  • Rivaroxaban
  • Reviparin
  • Reboxetine
  • Protriptyline
  • Protein C
  • Prednisone
  • Prednisolone
  • Prasugrel
  • Pralatrexate
  • Polythiazide
  • Phenprocoumon
  • Phenindione
  • Pentosan Polysulfate Sodium
  • Pemetrexed
  • Paroxetine
  • Parnaparin
  • Paramethasone
  • Opipramol
  • Nortriptyline
  • Nefazodone
  • Nadroparin
  • Milnacipran
  • Metolazone
  • Methylprednisolone
  • Methyclothiazide
  • Methotrexate
  • Melitracen
  • Meadowsweet
  • Lofepramine
  • Lithium
  • Levomilnacipran
  • Lepirudin
  • Indapamide
  • Imipramine
  • Iloprost
  • Hydroflumethiazide
  • Hydrocortisone
  • Hydrochlorothiazide
  • Heparin
  • Gossypol
  • Ginkgo
  • Furosemide
  • Fondaparinux
  • Fluvoxamine
  • Fluoxetine
  • Fluocortolone
  • Feverfew
  • Ethacrynic Acid
  • Escitalopram
  • Eptifibatide
  • Epoprostenol
  • Eplerenone
  • Enoxaparin
  • Edoxaban
  • Duloxetine
  • Doxepin
  • Dothiepin
  • Dipyridamole
  • Digoxin
  • Dibenzepin
  • Diazoxide
  • Dexamethasone
  • Desvenlafaxine
  • Desirudin
  • Desipramine
  • Deflazacort
  • Danaparoid
  • Dalteparin
  • Dabigatran Etexilate
  • Cyclosporine
  • Cyclopenthiazide
  • Cortisone
  • Clopidogrel
  • Clopamide
  • Clomipramine
  • Citalopram
  • Cilostazol
  • Chlorthalidone
  • Chlorothiazide
  • Certoparin
  • Cangrelor
  • Bumetanide
  • Budesonide
  • Bivalirudin
  • Betamethasone
  • Beta Glucan
  • Benzthiazide
  • Bendroflumethiazide
  • Bemiparin
  • Argatroban
  • Ardeparin
  • Apixaban
  • Anagrelide
  • Amoxapine
  • Amitriptylinoxide
  • Amitriptyline
  • Amineptine
  • Amiloride
  • Acenocoumarol
  • Abciximab

Taking ketorolac with the medications below could cause some side effects to increase, however the combination of both medications could prove to be the most optimal form of treatment for your unique situation. If you are prescribed both medications, your physician may alter the dose or frequency for one or both medications.

  • Zofenopril
  • Valsartan
  • Trandolapril
  • Timolol
  • Temocapril
  • Telmisartan
  • Spirapril
  • Sotalol
  • Ramipril
  • Quinapril
  • Propranolol
  • Practolol
  • Pindolol
  • Perindopril
  • Pentopril
  • Penbutolol
  • Oxprenolol
  • Olmesartan
  • Nebivolol
  • Nadolol
  • Moexipril
  • Metoprolol
  • Metipranolol
  • Losartan
  • Lisinopril
  • Levobunolol
  • Labetalol
  • Irbesartan
  • Imidapril
  • Fosinopril
  • Esmolol
  • Eprosartan
  • Enalaprilat
  • Enalapril
  • Delapril
  • Cilazapril
  • Celiprolol
  • Carvedilol
  • Carteolol
  • Captopril
  • Candesartan
  • Bisoprolol
  • Betaxolol
  • Benazepril
  • Azilsartan Medoxomil
  • Azilsartan
  • Atenolol
  • Alacepril
  • Acebutolol

Other Interactions

Severe accidents can take place if this medication is combined with alcohol. Avoid combining ketolerac with alcohol at all costs.

Also take caution when eating or drinking regular foods and drinks as some medications should not be taken near mealtime due to the possibility of interactions. Using tobacco with specific kinds of food could also trigger interactions to take place. Consult with your medical care professional how ketorolac impacts tobacco, alcohol, or food use.

Medical Interactions

Patients who have other kinds of medical issues could experience impacts in the usefulness of ketorolac. Always inform your health care professional if you are experiencing other medical issues, specifically:

  • Upcoming surgery (major)
  • Ulcerative colitis (history of ' take caution, conditions could be made worse)
  • Stroke (history of)
  • Stomach bleeding, ulcers, or perforation (or history of)
  • Pain relief from childbirth or labor (patients giving birth shortly should not use)
  • Nonsteroidal anti-inflammatory medicines or aspirin allergy
  • Liver disease (or history of)
  • Kidney disease (severe)
  • Kidney disease (or history of)
  • Hypertension (high blood pressure)
  • Hyperkalemia (high levels of potassium in blood)
  • Heart surgery (coronary artery bypass graft) this medication should not treat pain prior to or following surgery
  • Heart disease
  • Heart attack (history of, or recent)
  • Ethylenediamine tetraacetic acid allergy
  • Edema (body swelling or fluid retention)
  • Crohn's disease (history of)
  • Congestive heart failure
  • Blood clotting issues
  • Bleeding issues
  • Asthma patients sensitive to aspirin (history of)
  • Anemia

Warnings

It is highly essential that a physician monitors your progress while you are taking this medication. This will give your healthcare professional an opportunity to see if the drug is working as it should, and it will give them a chance to decide if it is beneficial for you to keep taking this medication.

Other forms of ketorolac should not be taken (tablet or injection) unless instructed by your physician. Other types of NSAIDs are diclofenac, Voltaren®, Motrin®, Ecotrin®, Celebrex®, Aleve®, Advil®, naproxen, ibuprofen, diclofenac, and aspirin. Ketorolac should not be taken at the same time as Trental® (pentoxifylline) or Benemid® (probenecid).

Intestinal or stomach bleeding could occur due to this medication. This can take place without any signs of warning. These side effects are more likely to take place if you've experienced a stomach ulcer, if you drink alcohol or smoke regularly, have poor health, are over age 60, or if you are taking other kinds of medications (such as a blood thinner or steroids). Contact your physician immediately if you have tarry, black stools; severe stomach heartburn or pain; or if you are vomiting material similar in appearance to coffee grounds or blood.

This drug could cause a severe allergic reaction known as anaphylaxis. While this is rare, it could take place more frequently for patients allergic to any nonsteroidal anti-inflammatory drugs, such as aspirin. This condition could be life threatening and necessitates urgent medical care. The symptoms of this condition are fainting, gasping for breath, or irregular or fast breathing. Other symptoms could include shifts in skin color (mainly of the face), quick but irregular pulse or heartbeat, swelling of area around eyes or eyelids, or hive-like swellings on top of the skin. If these side effects take place, immediately seek emergency medical care.

This medication could raise the likelihood of you having a stroke, heart attack, or blood clots. This is more common for individuals who have experienced heart disease in the past. Contact your physician immediately if you have chest discomfort or pain, fast or irregular heartbeat, severe heartburn or indigestion, sweating, nausea, or difficulty breathing.

Consult with your physician immediately if you have tenderness or pain in the upper stomach, yellow skin or eyes, atypical weakness or tiredness, nausea, appetite loss, dark colored urine, or stools that are pale in color. These are all signals of a severe liver issue.

Some signs of warning to watch out for severe side effects could include yellow skin or eyes, vomiting of material similar in appearance to coffee grounds, vomiting blood; atypical weight gain; unusual bruising or bleeding; swelling of the lower legs, feet, fingers, or face; skin rash; serious stomach pain; reduced urination output; or tarry, black stools.

Signals of severe heart issues could also take place, specifically fast heartbeat, chest pain, irregular heartbeat, speech slurring, weakness, or unusual warmth of skin. Consult with your physician immediately if any of these warning signals are noticed.

This medication can trigger a severe kind of allergic reaction known as anaphylaxis. While this reaction is rare, it could take place more frequently for patients with allergies to nonsteroidal anti-inflammatory drugs, such as aspirin. Anaphylaxis is a condition that can be deadly, and this will require emergency medical care. The most severe symptoms of this reaction are extremely quick or irregular ways of breathing, fainting, or gasping for breath. Other symptoms could include shifts in facial skin color, quick yet irregular beating of the heart or pulse, swellings on skin that are hive-like, and swelling or puffiness around eyes or eyelids. If these symptoms take place, seek emergency care immediately.

Severe skin reactions can take place after taking this medication. Consult with your physician immediately if you are experiencing chills or fever; ulcers or sores on skin; skin rash or acne; red skin lesions; or loose areas, peeling, or blistering of the skin.

It is highly imperative to inform your physician if you are trying to become pregnant or if you are pregnant prior to taking this medication. Taking ketorolac while pregnant could cause harm to the baby who is unborn. Do not take ketorolac during the remaining portion of pregnancy unless instructed by your doctor.

Other medications should not be taken unless previously approved by your physician. This refers to nonprescription and prescription medications, as well as vitamin or herbal supplements.

When choosing whether or not a medication should be used, patients should compare the dangers of taking this medication against the benefits it could provide. This choice should be made carefully with your physician. Consider the following aspects before taking ketorolac:

Allergies

Be sure to inform your physician if you have experienced allergic or unusual reactions to ketorolac or other medications. Be sure to inform your doctor if you have other kinds of allergies, including to animals, preservatives, dyes, or foods. For any products you may take that are non-prescription, be sure to read the ingredients summary carefully.

Specific Demographic Use

Pediatric

Current research has not yet identified how ketorolac impacts the pediatric population in regards to its safety and efficacy.

Geriatric

Current research has not outlined any issues specific to the elderly population that could limit the effectiveness of this medication for elderly patients. However, elderly patients should take caution, due to the toxicity of the medication. Patients should be monitored closely while they are taking ketorolac, and patients should never exceed the suggested dose. Elderly patients typically have a greater likelihood of having bowel, stomach, liver, kidney, or heart issues that are age-related, and these could require a change in dose for geriatric patients taking ketorolac.

Pregnancy

There has been a risk demonstrated to the fetus when pregnant women take ketorolac. However, patients experiencing a serious disease or life-threatening situation could benefit from therapy as the benefits may outweigh the risks.

Breastfeeding

This medication has proven to be dangerous to babies when their mothers take ketorolac while breastfeeding. Women should seek an alternate medicine or they should discontinue taking ketorolac.

Storage

Always keep ketorolac far from children's reach. Do not keep medication that is expired or not required any longer. Ketorolac should be thrown away 24 after the bottle is opened and the first dose is taken. Consult with your physician to determine how to properly dispose of unused medication.

Prior to opening, keep the sealed container in the refrigerator. Keep it out of direct light and freezing temperatures. After the container is opened, keep the medication at room temperature, far from heat and direct sunlight.

Summary

Ketorolac is an nonsteroidal, anti-inflammatory medication that decreases pain and inflammation. This drug is a part of the first generation of NSAID medications.

As a nasal spray, ketolerac alleviates moderate to temperately severe pain, such as pain that takes place from surgery or comparably painful procedure.

This drug hinders the prostaglandins bodily synthesis.

Ketorolac can have extremely dangerous side effects. The chance of you experiencing a severe side effect will be increased in correlation with the amount of medication that is used and it depends on the duration for which the medication is taken. It is essential that this medication is not taken for longer than 5 consecutive days. Before taking this medication, discuss the potential dangers and benefits of this medication with your doctor.

This drug can only be acquired with a prescription from your doctor. It is only dispensed in the nasal spray form. It is currently distributed under the US brands Sprix and Toradol.