Ketorolac Iv/im

— THERAPEUTIC CATEGORIES —
  • Nonnarcotic analgesics

Ketorolac Iv/im Generic Name & Formulations

General Description

Ketorolac tromethamine 15mg/mL, 30mg/mL; for IM or IV inj; contains alcohol.

Pharmacological Class

NSAID (pyrrolo-pyrrole).

How Supplied

Contact supplier.

Ketorolac Iv/im Indications

Indications

Short-term management of moderately severe, acute pain requiring opioid-level analgesia.

Ketorolac Iv/im Dosage and Administration

Adult

Do not exceed 5 days' combined (inj + tabs) therapy or recommended dose (may use as-needed opioids for breakthrough pain if appropriate). 17–64yrs (normal renal function): 60mg IM or 30mg IV once; or, 30mg IM or IV every 6 hours. ≥65yrs, or <110lbs, or renal impairment: 30mg IM or 15mg IV once; or, 15mg every 6 hours.

Children

<17yrs: not established.

Ketorolac Iv/im Contraindications

Contraindications

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. Epidural or intrathecal inj. Labor & delivery.

Ketorolac Iv/im Boxed Warnings

Not Applicable

Ketorolac Iv/im Warnings/Precautions

Warnings/Precautions

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.

Ketorolac Iv/im Pharmacokinetics

See Literature

Ketorolac Iv/im Interactions

Interactions

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.

Ketorolac Iv/im Adverse Reactions

Adverse Reactions

Inj site pain, 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.

Ketorolac Iv/im Clinical Trials

See Literature

Ketorolac Iv/im Note

Notes

Formerly known under the brand name Toradol.

Ketorolac Iv/im Patient Counseling

See Literature