Ketorolac
Brand: Sprix (nasal); Toradol discontinued, tablets and injection generic only
Boxed warning
Serious cardiovascular thrombotic events (heart attack and stroke) and serious GI bleeding, ulceration, and perforation; contraindicated for pain around CABG surgery (prescription labeling). Also kidney failure, bleeding risk, and a 5-day maximum across all routes.
- Caution
- Contraindicated with active GI bleeding, kidney impairment, and before major surgery; total use limited to 5 days.
- Storage
- Injection: protect from light.
- Pregnancy
- Avoid from 20 weeks on: fetal kidney problems and low amniotic fluid, and ductus arteriosus closure after 30 weeks.
Common side effects
- Stomach ulcers and bleeding
- Kidney injury
- High blood pressure
- Bruising
Key interactions
- Additive bleeding risk with anticoagulants
- Additive kidney risk with ACE inhibitors and diuretics
- Do not combine with other NSAIDs
Counseling points
- Total use is limited to 5 days across all routes
- Take with food
- Report black stools or reduced urine output
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