Dosing & Uses
Dosage Forms & Strengths
intranasal
- 15.75mg per 100 microL spray; 8 sprays/1.7g bottle
Pain
Indicated for short-term (up to 5 days) management of moderate to moderately severe pain
<65 years: 31.5 mg (ie, 1 spray in each nostril) q6-8h; not to exceed 126 mg/day
<50 kg or ≥65 years: 15.75 mg (ie, 1 spray in only 1 nostril) q6-8h; not to exceed 63 mg/day
Also see Administration
Dosage Modifications
Renal impairment
- 1 spray (15.75 mg) in 1 nostril
- Total dose: 15.75 mg intranasal q6-8hr; not to exceed 4 doses (63 mg/day)
Hepatic Impairment
- Use caution; may cause elevation of liver enzymes; discontinued if symptoms of liver toxicity develop
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (45)
- aceclofenac
aceclofenac, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- acemetacin
acemetacin, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- aminolevulinic acid oral
aminolevulinic acid oral, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.
- aminolevulinic acid topical
ketorolac intranasal, aminolevulinic acid topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
- aspirin
aspirin, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- benazepril
ketorolac intranasal, benazepril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- captopril
ketorolac intranasal, captopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- celecoxib
celecoxib, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- diclofenac
diclofenac, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- diflunisal
diflunisal, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- enalapril
ketorolac intranasal, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- etodolac
etodolac, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- fenoprofen
fenoprofen, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- flurbiprofen
flurbiprofen, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- fosinopril
ketorolac intranasal, fosinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- ibuprofen
ibuprofen, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- ibuprofen IV
ibuprofen IV, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- indomethacin
indomethacin, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- ketoprofen
ketoprofen, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- lisinopril
ketorolac intranasal, lisinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- lornoxicam
lornoxicam, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- meclofenamate
meclofenamate, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- mefenamic acid
mefenamic acid, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- meloxicam
meloxicam, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- methotrexate
ketorolac intranasal increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug. The relative risk of interaction of different NSAIDs w/methotrexate is not established. Selective COX 2 inhibitors are believed to have minimal interaction. Greater risk in pts. with renal impairment. Greater toxicity with high dose methotrexate (e.g., anti neoplastic regimen).
- methyl aminolevulinate
ketorolac intranasal, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
- moexipril
ketorolac intranasal, moexipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- nabumetone
nabumetone, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- naproxen
naproxen, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- oxaprozin
oxaprozin, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- parecoxib
parecoxib, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- pemetrexed
ketorolac intranasal increases levels of pemetrexed by unspecified interaction mechanism. Avoid or Use Alternate Drug. Especially in pts. w/mild moderate renal insufficiency. D/C NSAIDs 2 5 d before and 2 d after pemetrexed administration.
- perindopril
ketorolac intranasal, perindopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- piroxicam
piroxicam, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- probenecid
probenecid increases levels of ketorolac intranasal by decreasing renal clearance. Contraindicated.
- quinapril
ketorolac intranasal, quinapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- ramipril
ketorolac intranasal, ramipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- salicylates (non-asa)
salicylates (non-asa), ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- salsalate
salsalate, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- sulfasalazine
sulfasalazine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- sulindac
sulindac, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- tolfenamic acid
tolfenamic acid, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- tolmetin
tolmetin, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- trandolapril
ketorolac intranasal, trandolapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (211)
- acebutolol
acebutolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - aceclofenac
aceclofenac and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
aceclofenac and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - acemetacin
acemetacin and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
acemetacin and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - agrimony
ketorolac intranasal and agrimony both increase anticoagulation. Use Caution/Monitor.
- albuterol
ketorolac intranasal increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- alfalfa
ketorolac intranasal and alfalfa both increase anticoagulation. Use Caution/Monitor.
- alfuzosin
ketorolac intranasal decreases effects of alfuzosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- aliskiren
ketorolac intranasal will decrease the level or effect of aliskiren by Other (see comment). Use Caution/Monitor. In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs with drugs that affect RAAS may increase the risk of renal impairment (including acute renal failure) and cause loss of antihypertensive effect. Monitor renal function periodically.
- alteplase
ketorolac intranasal and alteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- American ginseng
ketorolac intranasal and American ginseng both increase anticoagulation. Use Caution/Monitor.
- amiloride
amiloride and ketorolac intranasal both increase serum potassium. Modify Therapy/Monitor Closely.
- antithrombin alfa
antithrombin alfa and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- antithrombin III
antithrombin III and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- arformoterol
ketorolac intranasal increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- argatroban
argatroban and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- asenapine
ketorolac intranasal decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- aspirin
aspirin and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
aspirin and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - atenolol
atenolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of atenolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - bemiparin
bemiparin and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- benazepril
benazepril, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- bendroflumethiazide
ketorolac intranasal increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- betaxolol
betaxolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of betaxolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - betrixaban
ketorolac intranasal, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor.
- bimatoprost
bimatoprost, ketorolac intranasal. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- bisoprolol
bisoprolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - bivalirudin
bivalirudin and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- budesonide
ketorolac intranasal, budesonide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- bumetanide
ketorolac intranasal increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
ketorolac intranasal decreases effects of bumetanide by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis. - candesartan
candesartan and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of candesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
candesartan, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - captopril
captopril, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- carbenoxolone
ketorolac intranasal increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- carvedilol
carvedilol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - celecoxib
celecoxib and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
celecoxib and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - celiprolol
celiprolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of celiprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - chlorothiazide
ketorolac intranasal increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- chlorpropamide
ketorolac intranasal increases effects of chlorpropamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- chlorthalidone
ketorolac intranasal increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- cinnamon
ketorolac intranasal and cinnamon both increase anticoagulation. Use Caution/Monitor.
- citalopram
citalopram, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.
- clomipramine
clomipramine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.
- clopidogrel
clopidogrel, ketorolac intranasal. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Clopidogrel and NSAIDs both inhibit platelet aggregation.
- cordyceps
ketorolac intranasal and cordyceps both increase anticoagulation. Use Caution/Monitor.
- cortisone
ketorolac intranasal, cortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- cyclopenthiazide
ketorolac intranasal increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- dabigatran
dabigatran and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor. Caution is advised, both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.
- dalteparin
dalteparin and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- defibrotide
defibrotide increases effects of ketorolac intranasal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Defibrotide may enhance effects of platelet inhibitors.
- deflazacort
ketorolac intranasal, deflazacort. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- dexamethasone
ketorolac intranasal, dexamethasone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- diclofenac
diclofenac and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
diclofenac and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - diflunisal
diflunisal and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
diflunisal and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - digoxin
ketorolac intranasal and digoxin both increase serum potassium. Use Caution/Monitor.
- dobutamine
ketorolac intranasal increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- dong quai
ketorolac intranasal and dong quai both increase anticoagulation. Use Caution/Monitor.
- dopexamine
ketorolac intranasal increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- doxazosin
ketorolac intranasal decreases effects of doxazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- drospirenone
drospirenone and ketorolac intranasal both increase serum potassium. Modify Therapy/Monitor Closely.
- duloxetine
duloxetine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- edoxaban
edoxaban, ketorolac intranasal. Either increases toxicity of the other by anticoagulation. Modify Therapy/Monitor Closely. Both drugs have the potential to cause bleeding, monitor closely. Promptly evaluate any signs or symptoms of blood loss.
- eltrombopag
eltrombopag increases levels of ketorolac intranasal by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF, ketorolac intranasal. Either increases toxicity of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine and tenofovir with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.
- enalapril
enalapril, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- enoxaparin
enoxaparin and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- ephedrine
ketorolac intranasal increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- epinephrine
ketorolac intranasal increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- epinephrine racemic
ketorolac intranasal increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- epoprostenol
ketorolac intranasal and epoprostenol both increase anticoagulation. Use Caution/Monitor.
- eprosartan
eprosartan and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of eprosartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
eprosartan, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - escitalopram
escitalopram, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- esmolol
esmolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of esmolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ethacrynic acid
ketorolac intranasal increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- etodolac
etodolac and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
etodolac and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - fennel
ketorolac intranasal and fennel both increase anticoagulation. Use Caution/Monitor.
- fenoprofen
fenoprofen and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
fenoprofen and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - feverfew
ketorolac intranasal and feverfew both increase anticoagulation. Use Caution/Monitor.
- fish oil triglycerides
fish oil triglycerides will increase the level or effect of ketorolac intranasal by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.
- fludrocortisone
ketorolac intranasal, fludrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- fluoxetine
fluoxetine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- flurbiprofen
flurbiprofen and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
flurbiprofen and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - fluvoxamine
fluvoxamine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.
- fondaparinux
fondaparinux and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- formoterol
ketorolac intranasal increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- forskolin
ketorolac intranasal and forskolin both increase anticoagulation. Use Caution/Monitor.
- fosinopril
fosinopril, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- furosemide
ketorolac intranasal increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- garlic
ketorolac intranasal and garlic both increase anticoagulation. Use Caution/Monitor.
- gemifloxacin
gemifloxacin, ketorolac intranasal. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- gentamicin
ketorolac intranasal increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- ginger
ketorolac intranasal and ginger both increase anticoagulation. Use Caution/Monitor.
- ginkgo biloba
ketorolac intranasal and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- glimepiride
ketorolac intranasal increases effects of glimepiride by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- glipizide
ketorolac intranasal increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- glyburide
ketorolac intranasal increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- heparin
heparin and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- horse chestnut seed
ketorolac intranasal and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
- hydralazine
ketorolac intranasal decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- hydrochlorothiazide
ketorolac intranasal increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- hydrocortisone
ketorolac intranasal, hydrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- ibuprofen
ibuprofen and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
ibuprofen and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - ibuprofen IV
ibuprofen IV and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
ibuprofen IV and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - indapamide
ketorolac intranasal increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- indomethacin
indomethacin and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
indomethacin and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - irbesartan
irbesartan and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of irbesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
irbesartan, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - isoproterenol
ketorolac intranasal increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- ketoprofen
ketoprofen and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
ketoprofen and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - labetalol
labetalol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - latanoprost
latanoprost, ketorolac intranasal. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- latanoprostene bunod ophthalmic
latanoprostene bunod ophthalmic, ketorolac intranasal. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- levalbuterol
ketorolac intranasal increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- levofloxacin
levofloxacin, ketorolac intranasal. Other (see comment). Modify Therapy/Monitor Closely. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.
- levomilnacipran
levomilnacipran, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.
- lisinopril
lisinopril, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- lithium
ketorolac intranasal increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.
- lornoxicam
ketorolac intranasal and lornoxicam both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and lornoxicam both increase serum potassium. Use Caution/Monitor. - losartan
losartan and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of losartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
losartan, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - meclofenamate
meclofenamate and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.
meclofenamate and ketorolac intranasal both increase serum potassium. Use Caution/Monitor. - mefenamic acid
ketorolac intranasal and mefenamic acid both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and mefenamic acid both increase serum potassium. Use Caution/Monitor. - meloxicam
ketorolac intranasal and meloxicam both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and meloxicam both increase serum potassium. Use Caution/Monitor. - mesalamine
mesalamine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.
- metaproterenol
ketorolac intranasal increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- methotrexate
ketorolac intranasal will increase the level or effect of methotrexate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- methylprednisolone
ketorolac intranasal, methylprednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- metolazone
ketorolac intranasal increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- metoprolol
metoprolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of metoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - milnacipran
milnacipran, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- mistletoe
ketorolac intranasal increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- moexipril
moexipril, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- moxifloxacin
moxifloxacin, ketorolac intranasal. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- moxisylyte
ketorolac intranasal decreases effects of moxisylyte by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- mycophenolate
ketorolac intranasal will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- nabumetone
ketorolac intranasal and nabumetone both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and nabumetone both increase serum potassium. Use Caution/Monitor. - nadolol
nadolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - naproxen
ketorolac intranasal and naproxen both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and naproxen both increase serum potassium. Use Caution/Monitor. - nebivolol
nebivolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of nebivolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - nefazodone
nefazodone, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- nettle
ketorolac intranasal increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- norepinephrine
ketorolac intranasal increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- olmesartan
olmesartan and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of olmesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
olmesartan, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - oxaprozin
ketorolac intranasal and oxaprozin both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and oxaprozin both increase serum potassium. Use Caution/Monitor. - panax ginseng
ketorolac intranasal and panax ginseng both increase anticoagulation. Use Caution/Monitor.
- parecoxib
ketorolac intranasal and parecoxib both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and parecoxib both increase serum potassium. Use Caution/Monitor. - paroxetine
paroxetine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- pau d'arco
ketorolac intranasal and pau d'arco both increase anticoagulation. Use Caution/Monitor.
- penbutolol
penbutolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - perindopril
perindopril, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- phenindione
phenindione and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- phenoxybenzamine
ketorolac intranasal decreases effects of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- phentolamine
ketorolac intranasal decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- phytoestrogens
ketorolac intranasal and phytoestrogens both increase anticoagulation. Use Caution/Monitor.
- pindolol
pindolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - pirbuterol
ketorolac intranasal increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- piroxicam
ketorolac intranasal and piroxicam both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and piroxicam both increase serum potassium. Use Caution/Monitor. - pivmecillinam
pivmecillinam, ketorolac intranasal. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
pivmecillinam, ketorolac intranasal. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - potassium acid phosphate
ketorolac intranasal and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium chloride
ketorolac intranasal and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium iodide
potassium iodide and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
- pralatrexate
ketorolac intranasal increases levels of pralatrexate by decreasing renal clearance. Use Caution/Monitor.
- prasugrel
ketorolac intranasal, prasugrel. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Chronic use of NSAIDs with prasugrel may increase bleeding risk.
- prazosin
ketorolac intranasal decreases effects of prazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- prednisolone
ketorolac intranasal, prednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- prednisone
ketorolac intranasal, prednisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- probenecid
ketorolac intranasal will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- propranolol
propranolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of propranolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - protamine
protamine and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- quinapril
quinapril, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- ramipril
ramipril, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- reishi
ketorolac intranasal and reishi both increase anticoagulation. Use Caution/Monitor.
- reteplase
ketorolac intranasal and reteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- sacubitril/valsartan
sacubitril/valsartan and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
sacubitril/valsartan, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
ketorolac intranasal decreases effects of sacubitril/valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. - salicylates (non-asa)
ketorolac intranasal and salicylates (non-asa) both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor. - salmeterol
ketorolac intranasal increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- salsalate
ketorolac intranasal and salsalate both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and salsalate both increase serum potassium. Use Caution/Monitor. - sertraline
sertraline, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- Siberian ginseng
ketorolac intranasal and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.
- silodosin
ketorolac intranasal decreases effects of silodosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
ketorolac intranasal, sodium picosulfate/magnesium oxide/anhydrous citric acid. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May be associated with fluid and electrolyte imbalances.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ketorolac intranasal by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ketorolac intranasal by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sotalol
sotalol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of sotalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - sparsentan
ketorolac intranasal and sparsentan both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Coadministration of NSAIDS, including selective COX-2 inhibitors, may result in deterioration of kidney function (eg, possible kidney failure). Monitor for signs of worsening renal function with concomitant use with NSAIDs.
- spironolactone
spironolactone and ketorolac intranasal both increase serum potassium. Modify Therapy/Monitor Closely.
- succinylcholine
ketorolac intranasal and succinylcholine both increase serum potassium. Use Caution/Monitor.
- sulfasalazine
ketorolac intranasal and sulfasalazine both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and sulfasalazine both increase serum potassium. Use Caution/Monitor. - sulindac
ketorolac intranasal and sulindac both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and sulindac both increase serum potassium. Use Caution/Monitor. - tafluprost
tafluprost, ketorolac intranasal. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- telmisartan
telmisartan and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of telmisartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
telmisartan, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - temocillin
temocillin, ketorolac intranasal. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
temocillin, ketorolac intranasal. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - tenecteplase
ketorolac intranasal and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- terazosin
ketorolac intranasal decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- terbutaline
ketorolac intranasal increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- ticarcillin
ticarcillin, ketorolac intranasal. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
ticarcillin, ketorolac intranasal. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - timolol
timolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of timolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tolazamide
ketorolac intranasal increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- tolbutamide
ketorolac intranasal increases effects of tolbutamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- tolfenamic acid
ketorolac intranasal and tolfenamic acid both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and tolfenamic acid both increase serum potassium. Use Caution/Monitor. - tolmetin
ketorolac intranasal and tolmetin both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and tolmetin both increase serum potassium. Use Caution/Monitor. - tolvaptan
ketorolac intranasal and tolvaptan both increase serum potassium. Use Caution/Monitor.
- torsemide
ketorolac intranasal increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- trandolapril
trandolapril, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- travoprost ophthalmic
travoprost ophthalmic, ketorolac intranasal. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- trazodone
trazodone, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- triamcinolone acetonide injectable suspension
ketorolac intranasal, triamcinolone acetonide injectable suspension. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Concomitant use of NSAIDS and corticosteroids increases the risk of gastrointestinal side effects. .
- triamterene
triamterene and ketorolac intranasal both increase serum potassium. Modify Therapy/Monitor Closely.
- valsartan
valsartan and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
valsartan, ketorolac intranasal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - venlafaxine
venlafaxine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- vitamin K1 (phytonadione)
ketorolac intranasal increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- voclosporin
voclosporin, ketorolac intranasal. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- vortioxetine
ketorolac intranasal, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.
- zanubrutinib
ketorolac intranasal, zanubrutinib. Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.
- zotepine
ketorolac intranasal decreases effects of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Minor (73)
- aceclofenac
aceclofenac will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acemetacin
acemetacin will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acyclovir
ketorolac intranasal will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- alendronate
ketorolac intranasal, alendronate. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI ulceration.
- amikacin
ketorolac intranasal increases levels of amikacin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- aminohippurate sodium
ketorolac intranasal will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- anamu
ketorolac intranasal and anamu both increase anticoagulation. Minor/Significance Unknown.
- aspirin
aspirin will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- balsalazide
ketorolac intranasal will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- bendroflumethiazide
bendroflumethiazide will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefadroxil
cefadroxil will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefamandole
cefamandole will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefazolin
cefazolin will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefpirome
cefpirome will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ceftibuten
ceftibuten will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- celecoxib
celecoxib will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cephalexin
cephalexin will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorpropamide
ketorolac intranasal will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorthalidone
chlorthalidone will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- creatine
creatine, ketorolac intranasal. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction) Combination may have additive nephrotoxic effects.
- cyclopenthiazide
cyclopenthiazide will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- danshen
ketorolac intranasal and danshen both increase anticoagulation. Minor/Significance Unknown.
- devil's claw
ketorolac intranasal and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- diclofenac
diclofenac will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- diclofenac topical
diclofenac topical, ketorolac intranasal. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Although low, there is systemic exposure to diclofenac topical; theoretically, concomitant administration with systemic NSAIDS or aspirin may result in increased NSAID adverse effects.
- diflunisal
diflunisal will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- eplerenone
ketorolac intranasal decreases effects of eplerenone by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- etodolac
etodolac will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- fenoprofen
fenoprofen will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- feverfew
ketorolac intranasal decreases effects of feverfew by pharmacodynamic antagonism. Minor/Significance Unknown.
- flurbiprofen
flurbiprofen will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- furosemide
ketorolac intranasal decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- ganciclovir
ketorolac intranasal will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- gentamicin
ketorolac intranasal increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- hydrochlorothiazide
hydrochlorothiazide will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ibuprofen
ibuprofen will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ibuprofen IV
ibuprofen IV will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- imidapril
ketorolac intranasal decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- indapamide
indapamide will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- indomethacin
indomethacin will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketoprofen
ketoprofen will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- lornoxicam
ketorolac intranasal will increase the level or effect of lornoxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- meclofenamate
meclofenamate will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mefenamic acid
ketorolac intranasal will increase the level or effect of mefenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- meloxicam
ketorolac intranasal will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mesalamine
ketorolac intranasal will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- metolazone
metolazone will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- nabumetone
ketorolac intranasal will increase the level or effect of nabumetone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- naproxen
ketorolac intranasal will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- neomycin PO
ketorolac intranasal increases levels of neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- noni juice
ketorolac intranasal and noni juice both increase serum potassium. Minor/Significance Unknown.
- ofloxacin
ofloxacin, ketorolac intranasal. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.
- oxaprozin
ketorolac intranasal will increase the level or effect of oxaprozin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- parecoxib
ketorolac intranasal will increase the level or effect of parecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- paromomycin
ketorolac intranasal increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- pegaspargase
pegaspargase increases effects of ketorolac intranasal by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of bleeding events.
- piroxicam
ketorolac intranasal will increase the level or effect of piroxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- rivastigmine
rivastigmine increases toxicity of ketorolac intranasal by pharmacodynamic synergism. Minor/Significance Unknown. Increased GI symptoms.
- rose hips
rose hips will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- salicylates (non-asa)
ketorolac intranasal will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- salsalate
ketorolac intranasal will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- streptomycin
ketorolac intranasal increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- sulfasalazine
ketorolac intranasal will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- sulindac
ketorolac intranasal will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- tobramycin
ketorolac intranasal increases levels of tobramycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- tolfenamic acid
ketorolac intranasal will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- tolmetin
ketorolac intranasal will increase the level or effect of tolmetin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- triamterene
triamterene, ketorolac intranasal. Other (see comment). Minor/Significance Unknown. Comment: Risk of acute renal failure. Mechanism: NSAIDs decrease prostaglandin synthesis, which normally protect against nephrotoxicity.
ketorolac intranasal increases toxicity of triamterene by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity. - valganciclovir
ketorolac intranasal will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- vancomycin
ketorolac intranasal increases levels of vancomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in neonates.
- willow bark
ketorolac intranasal will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Adverse Effects
>10%
Nasal discomfort (15%)
Rhinalgia (13%)
1-10%
Increased lacrimation (5%)
Throat irritation (4%)
Oliguria (3%)
Rash (3%)
Bradycardia (2%)
Decreased urine output (2%)
Increased ALT and/or AST (2%)
Hypertension (2%)
Rhinitis (2%)
Warnings
Black Box Warnings
Limitations of use
- Total duration of use of intranasal alone or sequentially with and other ketorolac formulations should not exceed 5 days
Cardiovascular risk
- NSAIDs may increase risk of serious cardiovascular thrombotic events, myocardial infarction (MI), and stroke, which can be fatal; risk may increase with duration of use; patients with risk factors for or existing cardiovascular disease may be at greater risk; contraindicated for perioperative pain in the setting of CABG surgery (increased risk of MI and stroke)
Gastrointestinal risk
- NSAIDs increase risk of serious GI adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal; GI adverse events may occur at any time during use and without warning symptoms; elderly patients are at greater risk for serious GI events
Bleeding risk
- Inhibits platelet function and is contraindicated with suspected or confirmed cerebrovascular bleeding, hemorrhagic diathesis, incomplete hemostasis, or high risk of bleeding
Renal risk
- Contraindicated with advanced renal impairment and patients at risk for renal failure due to volume depletion
Contraindications
Hypersensitivity to ketorolac, other NSAID, aspirin, ethylenediamine tetraacetic acid (EDTA)
Active peptic ulcer disease, recent GI bleeding or perforation, or history of peptic ulcer disease or GI bleeding
History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
Prophylactic analgesic before any major surgery; during the perioperative period in the setting of coronary artery bypass graft (CABG) surgery; advanced renal disease or patients at risk for renal failure due to volume depletion
Labor and delivery
Breastfeeding women
Suspected or confirmed cerebrovascular bleeding, hemorrhagic diathesis, incomplete hemostasis, or those for whom hemostasis is critical
Coadministration with probenecid or pentoxifylline
Cautions
May lead to onset of new hypertension or exacerbate existing hypertension
NSAIDs may cause serious skin reactions (eg, exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis)
Common local adverse effects include mild and transient nasal discomfort and irritation
Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injury; patients at greatest risk include the elderly, or those with impaired renal function, hypovolemia, heart failure, liver dysfunction, salt depletion, and individuals taking diuretics, ACE inhibitors, or ARBs
Drug reaction with eosinophilia and systemic symptoms (DRESS)
- Drug Reaction reported in patients taking NSAIDs; some of these events have been fatal or life-threatening; DRESS typically, although not exclusively, presents with fever, rash, lymphadenopathy, and/or facial swelling
- Other clinical manifestations may include hepatitis, nephritis, hematological abnormalities, myocarditis, or myositis; sometimes symptoms of DRESS may resemble an acute viral infection
- Eosinophilia is often present; because this disorder is variable in its presentation, other organ systems not noted here may be involved
- Early manifestations of hypersensitivity, such as fever or lymphadenopathy, may be present even though rash is not evident; if such signs or symptoms are present, discontinue therapy and evaluate the patient immediately
Pregnancy & Lactation
Pregnancy
Use of NSAIDs can cause premature closure of fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment
Because of these risks, limit dose and duration of use between about 20 and 30 weeks of gestation, and avoid use at about 30 weeks of gestation and later in pregnancy
Use of NSAIDs at about 30 weeks gestation or later in pregnancy increases risk of premature closure of fetal ductus arteriosus
Avoid use of NSAIDs in women at about 30 weeks gestation and later in pregnancy, because NSAIDs can cause premature closure of fetal ductus arteriosus
Use of NSAIDs at about 20 weeks gestation or later in pregnancy has been associated with cases of fetal renal dysfunction leading to oligohydramnios, and in some cases, neonatal renal impairment
If an NSAID is necessary at about 20 weeks gestation or later in pregnancy, limit the use to the lowest effective dose and shortest duration possible; if treatment extends beyond 48 hours, consider monitoring with ultrasound for oligohydramnios; if oligohydramnios occurs, discontinue therapy and follow up according to clinical practice
Data from observational studies regarding other potential embryofetal risks of NSAID use in women in first or second trimesters of pregnancy are inconclusive
In animal studies, administration of prostaglandin synthesis inhibitors resulted in increased pre-and post-implantation loss
Prostaglandins also have been shown to have an important role in fetal kidney development; in published animal studies, prostaglandin synthesis inhibitors have been reported to impair kidney development when administered at clinically relevant doses
Lactation
Excreted in human milk
Limited data from one published study involving ten nursing mothers 2-6 days postpartum showed low levels of ketorolac in breast milk
Exercise caution when administering drug to a nursing woman; available information has not shown any specific adverse events in nursing infants; however, instruct patients to contact their infant’s health care provider if they note any adverse events
The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for the drug and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Inhibits synthesis of prostaglandins in body tissues by inhibiting at least 2 cyclooxygenase isoenzymes, cyclooxygenase-1 (COX-1) and -2 (COX-2)
May inhibit chemotaxis, may alter lymphocyte activity, decrease proinflammatory cytokine activity, and may inhibit neutrophil aggregation. These effects may contribute to its anti-inflammatory activity
Pharmacokinetics
Bioavailability: 60% (compared with 30 mg IM)
Peak plasma time: 0.75 hr
Peak plasma concentration: 1805.8 ng/mL
Protein bound: 99% (5% to albumin)
Vd: 13 L
Metabolism: By liver via hydroxylation and conjugation
Half-life: 5.24 hr; 6-19 hr with renal impairment
Excretion: 92% urine (~40% as metabolites); 6% feces
Administration
Intranasal Administration
Is not an inhaled product; do not inhale when administering this product
Do not use concomitantly with other formulations of ketorolac or other NSAIDs
Activate pump
- Activate the pump before using the bottle for the FIRST time, activate the pump
- To activate the pump, hold the bottle at arm’s length away from the body with index finger and middle finger resting on the top of the finger flange and thumb supporting the base
- Press down evenly and release the pump 5 times; patient may not see a spray the first few times it is pressed down
- No need to activate the pump again if more doses are used from the bottle
Patient instructions
Step 1
- Blow nose gently to clear nostrils
- Sit up straight or stand; tilt head slightly forward
- Insert the tip of the container into your right nostril
- Point the container away from the center of your nose
- Hold your breath and spray once into your right nostril, pressing down evenly on both sides
- Immediately after administration, resume breathing through mouth to reduce expelling the product
- Also pinch the nose to help retain the spray if it starts to drip
- If only one spray per dose is prescribed, administration is complete; skip to Step 3 below
Step 2
- If a dose of 2 sprays is prescribed, repeat the process in Step 1 for the left nostril
- Again, be sure to point the spray away from the center of nose
- Spray once into the left nostril
Step 3
- Replace the clear plastic cover and place the bottle in a cool, dry location out of direct sunlight
- Keep out of reach of children
- Discard bottle within 24 hr after first priming, even if bottle still contains medication (will not deliver intended dose after 24 hr)
Storage
Protect from light and freezing
Refrigerate unopened bottle at 2-8°C (36-46°F)
Store at controlled room temperature during use, between 15-30°C (59-86°F), out of direct sunlight
Discard within 24 hr of priming
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 15 mg/mL vial |  | |
| ketorolac injection - | 15 mg/mL vial |  | |
| ketorolac injection - | 15 mg/mL vial |  | |
| ketorolac injection - | 30 mg/mL vial |  | |
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 15 mg/mL vial |  | |
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 15 mg/mL solution |  | |
| ketorolac injection - | 30 mg/mL solution |  | |
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 15 mg/mL vial |  | |
| ketorolac injection - | 15 mg/mL vial |  | |
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 15 mg/mL vial |  | |
| ketorolac injection - | 30 mg/mL solution |  | |
| ketorolac injection - | 15 mg/mL vial |  | |
| ketorolac injection - | 15 mg/mL vial |  | |
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 30 mg/mL (1 mL) vial |  | |
| ketorolac injection - | 15 mg/mL vial |  | |
| ketorolac ophthalmic (eye) - | 0.4 % drops |  | |
| ketorolac ophthalmic (eye) - | 0.5 % drops |  | |
| ketorolac ophthalmic (eye) - | 0.5 % drops |  | |
| ketorolac ophthalmic (eye) - | 0.5 % drops |  | |
| ketorolac ophthalmic (eye) - | 0.5 % drops |  | |
| ketorolac ophthalmic (eye) - | 0.5 % drops |  | |
| ketorolac ophthalmic (eye) - | 0.5 % drops |  | |
| ketorolac ophthalmic (eye) - | 0.5 % drops |  | |
| ketorolac ophthalmic (eye) - | 0.5 % drops |  | |
| ketorolac ophthalmic (eye) - | 0.5 % drops |  | |
| ketorolac ophthalmic (eye) - | 0.5 % drops |  | |
| ketorolac ophthalmic (eye) - | 0.5 % drops |  | |
| Acular LS ophthalmic (eye) - | 0.4 % drops |  | |
| Acular ophthalmic (eye) - | 0.5 % drops |  | |
| ketorolac intramuscular - | 60 mg/2 mL vial |  | |
| ketorolac intramuscular - | 60 mg/2 mL vial |  | |
| ketorolac intramuscular - | 60 mg/2 mL vial |  | |
| ketorolac intramuscular - | 60 mg/2 mL vial |  | |
| ketorolac intramuscular - | 60 mg/2 mL solution |  | |
| ketorolac intramuscular - | 60 mg/2 mL vial |  | |
| ketorolac intramuscular - | 60 mg/2 mL vial |  | |
| ketorolac intramuscular - | 60 mg/2 mL vial |  | |
| ketorolac intramuscular - | 60 mg/2 mL vial |  | |
| ketorolac intramuscular - | 60 mg/2 mL vial |  | |
| ketorolac intramuscular - | 60 mg/2 mL vial |  | |
| ketorolac intramuscular - | 60 mg/2 mL solution |  | |
| ketorolac intramuscular - | 60 mg/2 mL vial |  | |
| Sprix nasal - | 15.75 mg/spray liquid |  | |
| Sprix nasal - | 15.75 mg/spray liquid |  | |
| ketorolac nasal - | 15.75 mg/spray liquid |  | |
| ketorolac oral - | 10 mg tablet |  | |
| ketorolac oral - | 10 mg tablet |  | |
| ketorolac oral - | 10 mg tablet |  | |
| ketorolac oral - | 10 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
ketorolac injection
KETOROLAC - INJECTION
(KEE-toe-ROLE-ak)
COMMON BRAND NAME(S): Toradol
WARNING: It is important that you use this medication properly to help reduce your risk of side effects. Your doctor may adjust your dose if you are older, have low body weight, or have kidney problems.Nonsteroidal anti-inflammatory drugs (including ketorolac) may rarely increase the risk for a heart attack or stroke. This effect can happen at any time while using this drug but is more likely if you use it for a long time. The risk may be greater in older adults or if you have heart disease or increased risk for heart disease (for example, due to smoking, family history of heart disease, or conditions such as high blood pressure or diabetes). Talk to your doctor about the benefits and risks of using this drug.This drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. This effect can occur without warning at any time while using this drug. Older adults may be at higher risk for this effect. Do not use this medication if you have stomach/intestinal problems (such as bleeding, ulcers).Stop using ketorolac and get medical help right away if you notice any of the following rare but serious side effects: stomach/abdominal pain that doesn't go away, bloody or black/tarry stools, vomit that looks like coffee grounds, chest/jaw/left arm pain, shortness of breath, unusual sweating, weakness on one side of the body, sudden vision changes, trouble speaking.Do not use this drug right before or after heart bypass surgery (CABG) or before any surgery. It also should not be used during labor/delivery or in people with severe kidney problems or high risk for kidney problems. Do not use ketorolac if you are taking high doses of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). See also Drug Interactions section.
USES: Ketorolac is used for the short-term treatment of moderate to severe pain. It is usually used before or after medical procedures or after surgery. Reducing pain helps you recover more comfortably so that you can return to your normal daily activities. This medication is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation. This effect helps to decrease swelling, pain, or fever.Ketorolac should not be used for mild or long-term painful conditions (such as arthritis).
HOW TO USE: Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using ketorolac. If you have any questions, ask your doctor or pharmacist.This medication is given by injection into a muscle or vein as directed by your doctor. It may be given as a one-time dose or given on a regular schedule. If given on a regular schedule, it is usually injected every 6 hours as needed, or as directed by your doctor. This drug must not be injected into the spine.Dosage is based on your medical condition and response to treatment. To reduce your risk of stomach bleeding and other side effects, use this medication at the lowest effective dose for the shortest possible time. Do not increase your dose, use it more frequently, or use it for longer than 5 days. If you still have pain after 5 days, talk with your doctor about other medications you may use.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.If you have "breakthrough" pain while using this medication, ask your doctor about other medications that you can use with this drug. Tell your doctor if your condition worsens or if your pain is not relieved.
SIDE EFFECTS: See also Warning section.Pain at the injection site, dizziness, drowsiness, headache, or upset stomach may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: headache that is severe or doesn't go away, fainting, fast/pounding heartbeat, hearing changes (such as ringing in the ears), mental/mood changes (such as confusion, depression), stomach pain, vision changes (such as blurred vision), easy bruising/bleeding, signs of kidney problems (such as change in the amount of urine), symptoms of meningitis (such as unexplained stiff neck, fever), symptoms of heart failure (such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).This drug may rarely cause serious (possibly fatal) liver disease. Get medical help right away if you have any symptoms of liver damage, including: nausea/vomiting that doesn't stop, dark urine, stomach/abdominal pain, yellowing eyes/skin.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using ketorolac, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other nonsteroidal anti-inflammatory drugs-NSAIDs (such as ibuprofen, naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), bleeding or clotting problems, blood disorders (such as anemia), heart disease (such as previous heart attack), high blood pressure, liver disease, growths in the nose (nasal polyps), throat/stomach/intestinal problems (such as bleeding, heartburn, ulcers), stroke, swelling of the ankles/feet/hands.Kidney problems can sometimes occur with the use of NSAID medications, including ketorolac. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have a change in the amount of urine.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medicine may cause stomach/intestinal bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be at greater risk for stomach/intestinal bleeding, kidney problems, heart attack, and stroke while using this drug.Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks. Tell your doctor if you are pregnant or if you plan to become pregnant. This medication may harm an unborn baby and cause problems with normal labor/delivery. It is not recommended for use in pregnancy from 20 weeks until delivery. If your doctor decides that you need to use this medication between 20 and 30 weeks of pregnancy, you should use the lowest effective dose for the shortest possible time. You should not use this medication after 30 weeks of pregnancy.This drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as valsartan, losartan), corticosteroids (such as prednisone), methotrexate, probenecid, other medications that may affect the kidneys (including cidofovir), "water pills" (diuretics such as furosemide).This medication may increase the risk of bleeding when used with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.This medication can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include lithium, pemetrexed, among others.Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen or naproxen). These drugs are similar to ketorolac and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe stomach pain, vomit that looks like coffee grounds, extreme drowsiness, slow/shallow breathing.
NOTES: Do not share this medication with others.Lab and/or medical tests (including blood pressure, kidney function) may be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.This medication has been prescribed for your current condition only. Do not use it later for another condition unless your doctor directs you to do so. A different medication may be necessary in that case.
MISSED DOSE: It is important to get each dose of this medication as scheduled. If you are using this drug on a regular schedule (not "as needed") and you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised March 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
