Follow Us Follow us on Twitter Follow us on Facebook Follow us on … This systematic review was performed according to the guidelines established by the PRISMA statement.6 This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Intramuscular Administration Inject slowly and deeply into a … This is a decision you and your doctor will make. Contraindicated in active or history of peptic ulcer disease, recent gastrointestinal bleeding or perforation, or history of gastrointestinal bleeding. It will not cause physical or mental dependence, as narcotics can. It would be unusual to give Toradol (ketorolac) in a combined single dose via both the IV route and the IM route as it goes against the guidelines set forth for the drug. NDC #: 00409-3795-01. This site complies with the HONcode standard for trustworthy health information: verify here. If you notice any other effects, check with your healthcare professional. Do not double doses. Bolus intravenous doses should be given over no less than 15 seconds. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. Hypersensitivity reactions, ranging from bronchospasm to anaphylactic shock, have occurred. Therefore, do not take acetaminophen (e.g., Tylenol) together with ketorolac for more than a few days, unless otherwise directed by your medical doctor or dentist. Ketorolac injection is used for the short-term relief of moderately severe pain in people who are at least 17 years of age. Long-term use of this medicine can damage your kidneys or cause bleeding. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Other side effects not listed may also occur in some patients. For non-prescription products, read the label or package ingredients carefully. You will receive your first doses of ketorolac by intravenous (into a vein) or intramuscular (into a muscle) injection in a hospital or medical office. Our general interest e-newsletter keeps you up to date on a wide variety of health topics. KETOROLAC (kee toe ROLE ak) is a non-steroidal anti-inflammatory drug (NSAID). This helps to prevent irritation that may lead to trouble in swallowing. This product is available in the following dosage forms: Portions of this document last updated: Feb. 01, 2021. Drug information provided by: IBM Micromedex. It belongs to the group of medicines called nonsteroidal anti-inflammatory drugs (NSAIDs). May cause peptic ulcers, gastrointestinal bleeding, or potentially fatal stomach or intestinal perforation. Sign up now. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. The recommended total daily dose of tablets (maximum 40 mg/day) is significantly lower than for the injection (maximum 120 mg/day). Injection route (Solution) Ketorolac tromethamine is indicated for short term use only (up to 5 days total duration, including IV/IM and oral therapy in adults) for the management of moderately severe acute pain that requires analgesia at the opioid level. Other brands: Toradol, Toradol IV/IM, Sprix, aspirin, acetaminophen, tramadol, Tylenol, naproxen, oxycodone, fentanyl, ketorolac, Toradol, bupivacaine. Ketorolac should be used only when it is ordered by your doctor for treating certain kinds of pain. This medicine is for injection … Using ketorolac with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions. Using ketorolac with any of the following medicines is usually not recommended, but may be required in some cases. The following information includes only the average doses of this medicine. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Free E-newsletter Subscribe to Housecall . Non‐steroidal anti‐inflammatory drugs inhibit the action of the enzyme cyclo‐oxygenase at peripheral nociceptors and therefore the synthesis of inflammatory mediators derived from arachidonic acid. Ketorolac has side effects that can be very dangerous. Ketorolac injection should not be used for longer than 5 days, for mild pain, or for pain from chronic (long-term) conditions. Not for use in pediatric patients and not indicated for minor or chronic pain. You must stop taking oral ketorolac and using ke… INDICATIONS AND CLINICAL USE Intramuscular injection of Ketorolac Tromethamine Injection USP is indicated for: The following information includes only the average doses of ketorolac. Oral daily doses beyond label recommendations increase the risk for serious adverse events and do not improve efficacy. The injection should not be injected directly into the veins (intravenously). Ketorolac is not a narcotic and is not habit-forming. Specialist Registrar, Department of Anaesthesia, Guy's Hospital, St. Thomas Street, London SE1 9RT, UK. The combined duration of use of parenteral, oral, and nasal ketorolac should not exceed 5 days; the oral formulation is only to be used as continuation to IV or IM therapy. By intramuscular injection, or by intravenous injection. When you are taking ketorolac, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. Injection-Ketorolac injection may be used as a single or multiple doses, on a regular or when necessary schedule for the management of moderately severe, acute pain that requires analgesia at the opioid level, usually in a postoperative setting. Adjust dosages for elderly patients, patients under 50 kg, and patients with moderately elevated serum creatinine. Contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery. These side effects may go away during treatment as your body adjusts to the medicine. Mayo Clinic does not endorse companies or products. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. If you will be using ketorolac at home, your health care professional will teach you how the injections are to be given. Ketorolac tromethamine oral tablets are indicated for short term use only (up to 5 days total duration, including IV/IM and oral therapy in adults) for the management of moderately severe acute pain that requires analgesia at the opioid level and only as continuation treatment following IV or IM dosing of ketorolac tromethamine if necessary. Stomach or intestinal problems, swelling of the face, feet, or lower legs, or sudden decrease in the amount of urine may be especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of ketorolac. Not to worry unless hot, tender, and febrile. An oral tablet formulation was approved in 1991 at doses up to 40 mg/day for use after parenteral treatment. Route of Administration Dosage Form / Strength All Non-medicinal Ingredients Intramuscular 30 mg/mL solution Ethylalcohol10%(w/v), sodium chloride, sodium hydroxide and/or hydrochloric acid, water for injection. Toradol is available as 10 mg/mL (1%) and 30 mg/mL (3%) sterile solutions for injection for intramuscular (IM) administration only. -DOSAGE AND ADMINISTRATION: Tablets are only indicated as continuation therapy to injection, and the combined duration of use is not to exceed 5 days because of the increased risk of serious adverse events. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. © 1998-2021 Mayo Foundation for Medical Education and Research (MFMER). Ketorolac Tromethamine Injection, USP is available for intravenous (IV) or intramuscular Ketorolac has side effects that can be very dangerous. Sections. Swelling of face, fingers, lower legs, ankles, and/or feet, sores, ulcers, or white spots on lips or in mouth, Abdominal or stomach pain, cramping, or burning that is severe, bleeding from the rectum or bloody or black, tarry stools, burning, red, tender, thick, scaly, or peeling skin, decrease in amount of urine that is sudden, fast, irregular, noisy, or troubled breathing, fever with severe headache, drowsiness, confusion, and stiff neck or back, fever with or without chills or sore throat, hallucinations (seeing, hearing, or feeling things that are not there), increase in amount of urine or urinating often, nausea, heartburn, or indigestion that is severe and continues, pain, tenderness, or swelling in the upper stomach area, puffiness or swelling of the eyelids or eyes, tightness in the chest with or without wheezing, vomiting of blood or material that looks like coffee grounds, Abdominal or stomach pain (mild or moderate), feeling of fullness in abdominal or stomach area. injection formulation at doses up to 120 mg/d. Bolus intravenous doses should be given over no less than 15 seconds. View the full Prescribing Information. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Follow your doctor's orders or the directions on the label. Ketorolac is used to relieve moderately severe pain, usually pain that occurs after an operation or other painful procedure. Major surgery: Contraindicated for prophylactic analgesia; contraindicated for treatment of perioperative pain in setting of CABG surgery Ketorolac. Because of the risk of serious side effects, do not save any leftover ketorolac for use in the future, and do not share it with other people. Also, do not take any of the following medicines together with ketorolac, unless your medical doctor or dentist has directed you to do so and is following your progress: Ketorolac may cause some people to become dizzy or drowsy. Trough levels averaged 0.29 mcg/mL (SD ± 0.13) on Day 1 and 0.55 mcg/mL (SD ± 0.23) on Day 6. This medicine should not be used for more than 5 days. Search for more papers by this author. Is Toradol (ketorolac) considered a narcotic? Ketorolac (Oral Route, Injection Route) Print. Ketorolac tromethamine has a pKa of 3.5 and an n-octanol/water partition coefficient of 0.26. Also, signs of serious heart problems could occur such as chest pain, tightness in chest, fast or irregular heartbeat, or unusual flushing or warmth of skin. Hypersensitivity to ketorolac, aspirin or other NSAIDs. If you miss a dose of ketorolac, take it as soon as possible. About 92% of a given dose is found in the urine, approximately 40% as metabolites and 60% as unchanged ketorolac. Ketorolac tromethamine may exist in three crystal forms. You may report side effects to the FDA at 1-800-FDA-1088. Select one or more newsletters to continue. In the workplace, ketorolac tromethamine should be considered a combustible liquid, a potent drug, and potentially irritating to the eyes and respiratory tract. Additional Product Details. Ketorolac IV/IM prescription and dosage sizes information for physicians and healthcare professionals. Approximately 6% of a dose is excreted in the feces. The recommended intravenous dosage of ketorolac in children is 0.5 mg/kg, followed either by bolus injections of 1.0 mg/kg every 6 hours or an intravenous infusion of 0.17 mg/kg/h. Ketorolac is available only with your doctor's prescription. The risk for serious and potentially fatal cardiovascular thrombotic events may increase with use, duration of use, and in patients with cardiovascular disease, or risk factors for cardiovascular disease. If given on a regular schedule, it is usually injected every 6 hours as needed, or as directed by your doctor. It is soluble in water and has a pKa of 3.54. Ketorolac is a white to off white crystalline substance which discolours on exposure to light. You will receive your first doses of ketorolac by intravenous (into a vein) or intramuscular (into a muscle) injection in a hospital or medical office. Ketorolac is not a narcotic and is not habit-forming. Intramuscular ketorolac (Toradol, no longer available for injection) is no more effective for pain syndromes than oral ibuprofen or other oral nonsteroidal anti-inflammatory agents. Ketorolac is used to relieve moderately severe pain, usually pain that occurs after an operation or other painful procedure. Contraindicated in patients receiving concomitant aspirin or NSAIDs, or as prophylactic analgesic before any major surgery. Action Date Submission Action Type Submission Classification Review Priority; Orphan Status Letters, … Schedule your appointment now for safe in-person care. C. Ong. A healthcare provider will give you the injection. Adults (patients 16 years of age and older)—One 10-milligram (mg) tablet four times a day, four to six hours apart. The risk of having a serious side effect increases with the dose of ketorolac and with the length of treatment. Over the last 20 years, numerous studies have been conducted involving ketorolac. Although not all of these side effects may occur, if they do occur they may need medical attention. Medically reviewed by Drugs.com. Stop taking ketorolac and check with your doctor immediately if you notice any of these warning signs. Although it is used clinically, systemic ketorolac is not indicated for use in pediatric patients (neonates, infants, children, or adolescents). Injection-Ketorolac injection may be used as a single or multiple doses, on a regular or when necessary schedule for the management of moderately severe, acute pain that requires analgesia at the opioid level, usually in a postoperative setting. Any parenteral route is going to relieve pain faster than oral. Make sure you tell your doctor if you have any other medical problems, especially: For safe and effective use of ketorolac, do not use more of it, do not use it more often, and do not use it for more than 5 days. Follow all directions on your prescription label. I have given Toradol 60mg IM in Vastus lateralis muscle to total knee patients and have given the same amount through deltoid route. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Over the last 20 years, numerous studies have been conducted involving ketorolac. The molecularweight of ketorolac tromethamine is 376.40. NDC Proprietary Name Non-Proprietary Name Dosage Form Route Name Company Name Product Type; 0023-2181: Acular : Ketorolac Tromethamine: Solution/ Drops: Ophthalmic H. L. Ashworth. Call your doctor for medical advice about side effects. This content does not have an English version. The risk will depend on how much of each medicine you take every day, and on how long you take the medicines together. Also, bleeding from the stomach or intestines is more likely to occur during ketorolac treatment in people with these conditions. You will also have a chance to practice giving injections. B 40 – 43 Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. Ketorolac injection is used for the short-term relief of moderately severe pain in people who are at least 17 years of age. Ketorolac is used for the short-term treatment of moderate to severe pain. This content does not have an Arabic version. For non-prescription products, read the label or package ingredients carefully. Generic Name: ketorolac (kee-toe-ROLE-ak). It is just that IV ibuprofen isn't a thing. Having a non-opiod parenteral analgesic to offer is indeed a wonderful thing! Before using this medicine, you should discuss with your doctor the good that this medicine can do as well as the risks of using it. Ketorolac is usually given first as an injection, and then as an oral (by mouth) medicine. In 1989, ketorolac became an approved nonsteroidal inflammatory drug (NSAID) for injectable use as an analgesic. Hypersensitivity to ketorolac, aspirin or other NSAIDs. About 92% of a given dose is found in the urine, approximately 40% as metabolites and 60% as unchanged Ketorolac. Hemophilia or other bleeding problems—Ketorolac may increase the chance of serious bleeding, Bleeding from the stomach or intestines (history of) or, Colitis, stomach ulcer, or other stomach or intestinal problems (or history of)—Ketorolac may make stomach or intestinal problems worse. The risk for serious and potentially fatal cardiovascular thrombotic events may increase with use, duration of use, and in patients with cardiovascular disease, or risk factors for cardiovascular disease. In 1989, ketorolac became an approved nonsteroidal inflammatory drug (NSAID) for injectable use as an analgesic. Children up to 16 years of age—Use and dose must be determined by your doctor. It is commonly used after surgery. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. Ketorolac Trometamol 30 mg/ml solution for injection is for administration by intramuscular or bolus intravenous injection. Do not keep outdated medicine or medicine no longer needed. Contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery. If either of these side effects occurs, do not drive, use machines, or do anything else that could be dangerous if you are not alert. If your dose is different, do not change it unless your doctor tells you to do so. INDICATIONS AND CLINICAL USE Intramuscular injection of Ketorolac Tromethamine Injection USP is indicated for: Ketorolac should not be used for longer than 5 days, including both injection plus tablets. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Adults (patients 16 years of age and older)—15 or 30 mg, injected into a muscle or a vein four times a day, at least 6 hours apart. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Ketorolac Tromethamine Injection, USP, is a solution containing ketorolac tromethamine, a non-steroidal anti-inflammatory agent. Taking certain other medicines together with ketorolac may increase the chance of unwanted effects. Last updated on Aug 20, 2020. Children, infants, neonates. Available for Android and iOS devices. Studies in older adults have shown that ketorolac stays in the body longer than it does in younger people. Therefore, do not take acetaminophen (e.g., Tylenol) together with ketorolac for more than a few days, unless otherwise directed by your medical doctor or dentist. Route of Administration shall consist of an alphabetic term which has a maximum length shall be restricted to 60 characters, with the hyphen and virgule being only punctuation permissible. Also, elderly people are more likely than younger adults to get very sick if the medicine causes stomach problems. Indications Please click the button below to view the full Prescribing Information. The total combined duration of use of oral ketorolac tromethamine and ketorolac tromethamine injection should not exceed 5 days. For ketorolac, the following should be considered: Tell your doctor if you have ever had any unusual or allergic reaction to ketorolac or any other medicines. Store at … Ketorolac tromethamine administered as an intravenous bolus, every 6 hours, for 5 days, to healthy subjects (n = 13), showed no significant difference in Cmax on Day 1 and Day 5. However, when the intramuscular route is selected, meticulous injection technique and dosage recommendations must be adhered to. Ketorolac is given as an injection, into a muscle by a doctor or trained nurse. ketorolac tromethamine (SPRIX) is described in this article. Contraindicated for intrathecal or epidural administration. Size: 30 mg/mL 1 mL/25 SDV. After that, your doctor may choose to continue your treatment with oral ketorolac. All rights reserved. Specialist Registrar, Department of Anaesthesia, St. Thomas' Hospital, London, UK . Drug Name Active Ingredients Strength Dosage Form/Route Marketing Status TE Code RLD RS; KETOROLAC TROMETHAMINE: KETOROLAC TROMETHAMINE: 30MG/ML: INJECTABLE;INJECTION Contraindicated in patients receiving concomitant aspirin or NSAIDs, or as prophylactic analgesic before any major surgery. The dose of this medicine will be different for different patients. Ketorolac tromethamine oral tablets are indicated for short term use only (up to 5 days total duration, including IV/IM and oral therapy in adults) for the management of moderately severe acute pain that requires analgesia at the opioid level and only as continuation treatment following IV or IM dosing of ketorolac tromethamine if necessary. Never heard of patients coming in with nodule-like areas from injection. It is usually used before or after medical procedures or after surgery. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem fo… subcutaneous ketorolac is appropriate when patients present in pain with no IV access and low muscle mass. It will not cause physical or mental dependence, as narcotics can. Drug class: Nonsteroidal anti-inflammatory drugs, Edema (swelling of face, fingers, feet or lower legs caused by too much fluid in the body) or, Systemic lupus erythematosus (SLE)—The chance of serious side effects may be increased. It may be given as a one-time dose or given on a regular schedule. Approximately 6% of a dose is excreted in the feces. However, possible warning signs often occur, including swelling of the face, fingers, feet, and/or lower legs; severe stomach pain, black, tarry stools, and/or vomiting of blood or material that looks like coffee grounds; unusual weight gain; and/or skin rash. The injection is given into a muscle, or into a vein through an IV. Use caution in elderly patients due to high risk of gastrointestinal adverse events. Route of Administration Dosage Form / Strength All Non-medicinal Ingredients Intramuscular 30 mg/mL solution Ethylalcohol10%(w/v), sodium chloride, sodium hydroxide and/or hydrochloric acid, water for injection. How long does ketorolac (Toradol) stay in your system? The influence of timing and route of administration of intravenous ketorolac on analgesia after hand surgery. May cause peptic ulcers, gastrointestinal bleeding, or potentially fatal stomach or intestinal perforation. In the UK the recommended initial dose by the parenteral route is 10 mg of ketorolac trometamol followed by 10 to 30 mg every 4 to 6 hours as required, although ketorolac may be given as often as every 2 hours in the initial postoperative period if required. Generic Name: Ketorolac. But that doesn't make it a better drug than ibuprofen. Advertising revenue supports our not-for-profit mission. Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. The amount of medicine that you take depends on the strength of the medicine. Short-term (≤5 days) management of moderately severe acute pain that requires analgesia at opioid level; not indicated for minor or chronic painful conditions. Contraindicated in patients with: advanced renal impairment, risk of renal failure due to volume depletion, cerebrovascular bleeding, hemorrhagic diathesis, incomplete hemostasis, or high-risk of bleeding. Ketorolac injection should not be used for longer than 5 days, for mild pain, or for pain from chronic (long-term) conditions.
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