Ketorolac IV/IM Rx
Generic Name and Formulations:
Ketorolac tromethamine 15mg/mL, 30mg/mL; for IM or IV inj; contains alcohol.
Various generic manufacturers
Indications for Ketorolac IV/IM:
Short-term management of moderately severe, acute pain requiring opioid-level analgesia.
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.
<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. Epidural or intrathecal inj. 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.
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.
Formerly known under the brand name Toradol.
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