Ketorolac (Systemic)

Brand name(s): Toradol

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ketorolac, the following should be considered:

Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to ketorolac or to any of the following medicines:

• Aspirin or other salicylates
• Diclofenac (e.g., Voltaren)
• Diflunisal (e.g., Dolobid)
• Etodolac (e.g., Lodine)
• Fenoprofen (e.g., Nalfon)
• Floctafenine (e.g., Idarac)
• Flurbiprofen (e.g., Ansaid)
• Ibuprofen (e.g., Motrin)
• Indomethacin (e.g., Indocin)
• Ketoprofen (e.g., Orudis)
• Meclofenamate (e.g., Meclomen)
• Mefenamic acid (e.g., Ponstel)
• Nabumetone (e.g., Relafen)
• Naproxen (e.g., Naprosyn)
• Oxaprozin (e.g., Daypro)
• Phenylbutazone (e.g., Butazolidin)
• Piroxicam (e.g., Feldene)
• Sulindac (e.g., Clinoril)
• Tenoxicam (e.g., Mobiflex)
• Tiaprofenic acid (e.g., Surgam)
• Tolmetin (e.g., Tolectin)

Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy-Studies on birth defects with ketorolac have not been done in pregnant women. However, it crosses the placenta. There is a chance that regular use of ketorolac during the last few months of pregnancy may cause unwanted effects on the heart or blood flow of the fetus or newborn baby. Ketorolac has not been shown to cause birth defects in animal studies. However, animal studies have shown that, if taken late in pregnancy, ketorolac may increase the length of pregnancy, prolong labor, or cause other problems during delivery.

Breast-feeding-Ketorolac passes into the breast milk and may cause unwanted effects in nursing babies. It may be necessary for you to use another pain reliever or to stop breast-feeding during treatment. Be sure that you have discussed the use of this medicine with your doctor.

Children-Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of ketorolac in children up to 16 years of age with use in other age groups.

Older adults-Stomach or intestinal problems, swelling of the face, feet, or lower legs, or sudden decrease in the amount of urine may be especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of ketorolac. Also, elderly people are more likely than younger adults to get very sick if the medicine causes stomach problems. Studies in older adults have shown that ketorolac stays in the body longer than it does in younger people. Your doctor will consider this when deciding on how much ketorolac should be given for each dose and how often it should be given.

Other medicines-Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using ketorolac, it is especially important that your health care professional know if you are taking any of the following:

• Anticoagulants (blood thinners) or
• Cefamandole (e.g., Mandol) or
• Cefoperazone (e.g., Cefobid) or
• Cefotetan (e.g., Cefotan) or
• Heparin or
• Plicamycin (e.g., Mithracin) or
• Valproic acid (e.g., Depakene)-Use of any of these medicines together with ketorolac may increase the chance of bleeding

• Aspirin or other salicylates or
• Other medicine for inflammation or pain, except narcotics-The chance of serious side effects may be increased

• Lithium (e.g., Lithane) or
• Methotrexate (e.g., Mexate)-Higher blood levels of lithium or methotrexate and an increased chance of side effects may occur

• Probenecid (e.g., Benemid)-Higher blood levels of ketorolac and an increased chance of side effects may occur

Other medical problems-The presence of other medical problems may affect the use of ketorolac. Make sure you tell your doctor if you smoke tobacco or if you have any other medical problems, especially:

• Alcohol abuse or
• Diabetes mellitus (sugar diabetes) or
• Edema (swelling of face, fingers, feet or lower legs caused by too much fluid in the body) or
• Kidney disease or
• Liver disease (severe) or
• Systemic lupus erythematosus (SLE)-The chance of serious side effects may be increased

• Asthma or
• Heart disease or
• High blood pressure-Ketorolac may make your condition worse.

• Bleeding in the brain (history of) or
• Hemophilia or other bleeding problems-Ketorolac may increase the chance of serious bleeding

• Bleeding from the stomach or intestines (history of) or
• Colitis, stomach ulcer, or other stomach or intestinal problems (or history of)-Ketorolac may make stomach or intestinal problems worse. Also, bleeding from the stomach or intestines is more likely to occur during ketorolac treatment in people with these conditions

Last Revised: 08/17/2000