Ketorolac

Ketorolac is a prescription NSAID used for short-term treatment of moderately severe acute pain. This guide covers ketorolac uses, how it works, dosage, side effects, precautions, drug interactions, use in pregnancy and breastfeeding and its approximate price in India.

What Is Ketorolac?

Ketorolac belongs to the same medicine family as ibuprofen and diclofenac. It is used for short-term pain relief, usually after surgery or injury, when a stronger non-opioid option is needed. It is given first as an injection in a clinic or hospital. Tablets, where used, only continue that treatment. Ketorolac does not treat the cause of pain and does not replace other care.

How Ketorolac Works

Ketorolac blocks enzymes called COX-1 and COX-2. This reduces the body’s production of prostaglandins, chemicals involved in pain and inflammation. The same action explains many of its risks. Prostaglandins also protect the stomach lining, help maintain kidney blood flow and support normal platelet function.

When Ketorolac Is Used

• Short-term management of moderately severe acute pain that needs an opioid-level analgesic, typically after surgery or other acute injury.
• The tablets are used only as a continuation after ketorolac injection treatment. They are not a starting treatment.

It is not intended for:

• minor pain, headaches or period pain managed with simpler painkillers;
• long-term or chronic pain;
• use before major surgery as a preventive painkiller, or for patients who may bleed during surgery.

Ketorolac Dosage and How It Is Given

Dosing is set by the treating doctor. Your doctor chooses the dose by age, body weight, kidney function and the type of pain. Do not use the numbers in any article to decide your own dose.

Key safety rules from the US labelling

• The total course, injection plus tablets, must not exceed 5 days.
• Tablets are used only after injection treatment, not as a first treatment.
• The usual daily maximum for tablets is 40 mg a day. The daily maximum for injection is 120 mg a day.
• The injection maximum is lower, 60 mg a day, for people aged 65 or older, with reduced kidney function, or weighing under 50 kg.
• Higher doses do not give better pain relief. They increase the risk of serious side effects.
• Do not combine ketorolac with other NSAIDs, including aspirin and ibuprofen, unless your doctor specifically directs it.
• Take tablets with food or milk, if your doctor advises, to reduce stomach upset.

If you miss a dose, do not take extra to catch up. Follow your prescriber’s instructions.

Side Effects of Ketorolac

Common (reported most often with NSAIDs, including ketorolac):

• stomach pain, indigestion, nausea
• headache, dizziness, drowsiness
• swelling in the legs or feet
• injection-site pain

Seek urgent medical help for:

• black, tarry or bloody stools, or vomiting blood
• chest pain, shortness of breath, weakness on one side, or slurred speech
• very little urine, or sudden swelling of the face, feet or hands
• rash, swelling of the lips or throat, wheezing, or trouble breathing
• unusual bruising or bleeding that will not stop
• yellow skin or eyes, or severe stomach pain

Stop the medicine and get emergency help if you think you are having an allergic reaction. Tell your doctor about any other side effect that worries you.

Ketorolac Precautions and Monitoring

Who should not receive ketorolac (formal contraindications)

Under US labelling, ketorolac should not be used in people who have

• active stomach or intestinal ulcers, or a history of GI bleeding or perforation
• suspected or confirmed bleeding in the brain, or a high risk of bleeding
• advanced kidney impairment, or a risk of kidney failure from low body fluid
• allergy to ketorolac, aspirin or other NSAIDs (including aspirin-triggered asthma)
• planned or recent coronary artery bypass graft (CABG) surgery
• labor and delivery (it may affect the baby’s circulation and uterine contractions)

Ketorolac is also not to be combined with aspirin or other NSAIDs, probenecid or pentoxifylline.

Precautions (use only with careful medical judgment)

• Heart disease, high blood pressure, heart failure or fluid retention
• Kidney or liver disease, dehydration
• Asthma, especially with nasal polyps
• Bleeding disorders, or use of blood thinners
• Older adults, who face a higher risk of serious complications

Monitoring

Doctors may check kidney function, blood pressure, signs of bleeding and fluid balance, especially in older adults and in people with kidney or heart conditions. Report any warning symptoms promptly.

Children

Ketorolac is not indicated for children in US labelling, and safety below 17 years has not been established. It should be used in a child only on specialist advice.

Ketorolac Drug Interactions

Tell your doctor about all medicines you use. Particular care is needed with:

• Aspirin and other NSAIDs: higher risk of bleeding and stomach damage. Combination is not recommended.
• Probenecid and pentoxifylline: contraindicated with ketorolac.
• Blood thinners (warfarin, heparin) and antiplatelet drugs: higher bleeding risk.
• Blood-pressure medicines (ACE inhibitors, ARBs, diuretics): NSAIDs can reduce their effect and increase the risk of kidney problems.
• Lithium, methotrexate and ciclosporin: blood levels or toxicity may increase.
• SSRIs and SNRIs (some antidepressants): may add to bleeding risk.
• Alcohol: can add to stomach irritation.

This list is not exhaustive.

Ketorolac in Pregnancy and Breastfeeding

• Pregnancy, from 20 weeks onward: The FDA advises avoiding NSAIDs at about 20 weeks of pregnancy or later, because they can cause rare but serious kidney problems in the unborn baby, leading to low amniotic fluid (oligohydramnios). If NSAID treatment is needed beyond about 48 hours, doctors may consider ultrasound monitoring of amniotic fluid.
• From about 30 weeks: NSAIDs may cause premature closure of a baby’s ductus arteriosus (a fetal blood vessel), so they should be avoided.
• During labor and delivery: Ketorolac is contraindicated.
• Earlier in pregnancy: Use only if clearly needed and prescribed by a doctor.
• Breastfeeding: Ketorolac passes into breast milk in small amounts. Do not use it while breastfeeding unless your doctor specifically advises it.

If you are pregnant, planning pregnancy or breastfeeding, tell your doctor before any ketorolac dose.

Ketorolac Brands, Strengths and Approximate Price in India

Prices below are listing-based approximate MRPs for the exact pack shown. They are not guaranteed current prices, and they vary by pharmacy, city and date. Always confirm with your pharmacist.

Notes:

• Pharmacies may sell below MRP. Listed selling prices at the time were ₹69.56 (Ketorol) and ₹92.40 (Ketanov). These are not MRPs.
• Injection and other dosage forms exist, but their prices could not be verified, so they are not listed.
• Ketorolac is a prescription medicine. Its brands are not interchangeable without your doctor’s or pharmacist’s guidance.
• This list is not exhaustive. Availability and prices can change.

How HealthPil Can Help

HealthPil helps you understand your medicines and prepare questions for your doctor. We do not replace medical advice. Never start, stop or change a painkiller based on an article alone.

You can consult a doctor online with HealthPil before starting, stopping or changing this medicine.