Toradol IV/IM

Generic name: Ketorolac
Drug class: Nonsteroidal anti-inflammatory drugs

Usage of Toradol IV/IM

Ketorolac is used to relieve moderately severe pain, usually pain that occurs after an operation or other painful procedure. It belongs to the group of medicines called nonsteroidal anti-inflammatory drugs (NSAIDs). Ketorolac is not a narcotic and is not habit-forming. It will not cause physical or mental dependence, as narcotics can. However, ketorolac is sometimes used together with a narcotic to provide better pain relief than either medicine used alone.

Ketorolac has side effects that can be very dangerous. The risk of having a serious side effect increases with the dose of ketorolac and with the length of treatment. Therefore, ketorolac should not be used for more than 5 days. 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 available only with your doctor's prescription.

Toradol IV/IM side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Swelling of face, fingers, lower legs, ankles, and/or feet

weight gain (unusual)

Less common

Bruising (not at place of injection)

high blood pressure

skin rash or itching

small, red spots on skin

sores, ulcers, or white spots on lips or in mouth

Rare

Abdominal or stomach pain, cramping, or burning that is severe

bleeding from the rectum or bloody or black, tarry stools

bloody or cloudy urine

blue lips and fingernails

blurred vision of other vision change

burning, red, tender, thick, scaly, or peeling skin

chest pain

convulsions

cough or hoarseness

dark urine

decrease in amount of urine that is sudden

fainting

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)

hearing loss

hives

increase in amount of urine or urinating often

light-colored stools

loss of appetite

low blood pressure

mood changes or unusual behavior

muscle cramps or pain

nausea, heartburn, or indigestion that is severe and continues

nosebleeds

pain in lower back and/or side

pain, tenderness, or swelling in the upper stomach area

painful or difficult urination

pale skin

puffiness or swelling of the eyelids or eyes

ringing or buzzing in ears

runny nose

severe restlessness

shortness of breath

swollen or painful glands

swollen tongue

thirst that continues

tightness in the chest with or without wheezing

unusual tiredness or weakness

vomiting of blood or material that looks like coffee grounds

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. 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:

More common

Abdominal or stomach pain (mild or moderate)

bruising at place of injection

diarrhea

dizziness

drowsiness

headache

indigestion

nausea

Less common or rare

Bloating or gas

burning or pain at place of injection

constipation

feeling of fullness in abdominal or stomach area

increased sweating

vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking Toradol IV/IM

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

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

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

Geriatric

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

Breast Feeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Aceclofenac

Acemetacin

Amtolmetin Guacil

Aspirin

Bromfenac

Bufexamac

Celecoxib

Choline Salicylate

Clonixin

Dexibuprofen

Dexketoprofen

Diclofenac

Diflunisal

Dipyrone

Droxicam

Etodolac

Etofenamate

Etoricoxib

Felbinac

Fenoprofen

Fepradinol

Feprazone

Floctafenine

Flufenamic Acid

Flurbiprofen

Ibuprofen

Indomethacin

Ketoprofen

Lornoxicam

Loxoprofen

Lumiracoxib

Meclofenamate

Mefenamic Acid

Meloxicam

Morniflumate

Nabumetone

Naproxen

Nepafenac

Niflumic Acid

Nimesulide

Nimesulide Beta Cyclodextrin

Oxaprozin

Oxyphenbutazone

Parecoxib

Pentoxifylline

Phenylbutazone

Piketoprofen

Piroxicam

Probenecid

Proglumetacin

Propyphenazone

Proquazone

Rofecoxib

Salicylic Acid

Salsalate

Sodium Salicylate

Sulfasalazine

Sulindac

Tenoxicam

Tiaprofenic Acid

Tolfenamic Acid

Tolmetin

Valdecoxib

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

ABCiximab

Acenocoumarol

Amiloride

Amineptine

Amitriptyline

Amitriptylinoxide

Amoxapine

Anagrelide

Apixaban

Ardeparin

Argatroban

Bemetizide

Bemiparin

Bendroflumethiazide

Benzthiazide

Betamethasone

Betrixaban

Bivalirudin

Budesonide

Bumetanide

Cangrelor

Certoparin

Chlorothiazide

Chlorthalidone

Cilostazol

Citalopram

Clomipramine

Clopamide

Clopidogrel

Cortisone

Cyclopenthiazide

Cyclosporine

Cyclothiazide

Dabigatran Etexilate

Dalteparin

Danaparoid

Deflazacort

Desipramine

Desirudin

Desmopressin

Desvenlafaxine

Dexamethasone

Diazoxide

Dibenzepin

Digoxin

Dipyridamole

Dothiepin

Doxepin

Duloxetine

Edoxaban

Emtricitabine

Enoxaparin

Eplerenone

Epoprostenol

Eptifibatide

Escitalopram

Ethacrynic Acid

Etozolin

Feverfew

Fluocortolone

Fluoxetine

Fluvoxamine

Fondaparinux

Furosemide

Ginkgo

Gossypol

Heparin

Hydrochlorothiazide

Hydrocortisone

Hydroflumethiazide

Iloprost

Imipramine

Indapamide

Inotersen

Lepirudin

Levomilnacipran

Lithium

Lofepramine

Meadowsweet

Melitracen

Melphalan

Methotrexate

Methyclothiazide

Methylprednisolone

Metolazone

Milnacipran

Nadroparin

Nefazodone

Nortriptyline

Opipramol

Paramethasone

Parnaparin

Paroxetine

Pemetrexed

Pentosan Polysulfate Sodium

Phenindione

Phenprocoumon

Piretanide

Polythiazide

Potassium Citrate

Prasugrel

Prednisolone

Prednisone

Protein C

Protriptyline

Quinethazone

Reviparin

Rivaroxaban

Selexipag

Sertraline

Sibutramine

Spironolactone

Sulfinpyrazone

Sulodexide

Tacrolimus

Tenofovir Alafenamide

Tenofovir Disoproxil Fumarate

Tianeptine

Ticagrelor

Ticlopidine

Tinzaparin

Tirofiban

Torsemide

Trazodone

Treprostinil

Triamterene

Trichlormethiazide

Trimipramine

Venlafaxine

Vilazodone

Vorapaxar

Vortioxetine

Warfarin

Xipamide

Using this medicine 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. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acebutolol

Atenolol

Azilsartan

Azilsartan Medoxomil

Benazepril

Betaxolol

Bisoprolol

Candesartan

Captopril

Carteolol

Carvedilol

Celiprolol

Enalapril

Enalaprilat

Eprosartan

Esmolol

Fosinopril

Irbesartan

Labetalol

Levobunolol

Lisinopril

Losartan

Metipranolol

Metoprolol

Moexipril

Nadolol

Nebivolol

Olmesartan

Oxprenolol

Penbutolol

Perindopril

Pindolol

Propranolol

Quinapril

Ramipril

Sotalol

Spirapril

Telmisartan

Timolol

Trandolapril

Valsartan

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Relate drugs

How to use Toradol IV/IM

For patients taking ketorolac tablets:

To lessen stomach upset, ketorolac tablets should be taken with food (a meal or a snack) or with an antacid.

Take this medicine with a full glass of water. Also, do not lie down for about 15 to 30 minutes after taking it. This helps to prevent irritation that may lead to trouble in swallowing.

For patients using ketorolac injection:

Medicines given by injection are sometimes used at home. If you will be using ketorolac at home, your health care professional will teach you how the injections are to be given. You will also have a chance to practice giving injections. Be certain that you understand exactly how the medicine is to be injected.

For safe and effective use of this medicine, do not use more of it, do not use it more often, and do not use it for more than 5 days. Using too much of this medicine increases the chance of unwanted effects, especially in elderly patients.

Ketorolac should be used only when it is ordered by your doctor for treating certain kinds of pain. 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.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. 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.

For oral dosage form (tablets):

For pain:

Adults (patients 16 years of age and older)—One 10-milligram (mg) tablet four times a day, four to six hours apart. Some people may be directed to take two tablets for the first dose only.

Children up to 16 years of age—Use and dose must be determined by your doctor.

For injection dosage form:

For pain:

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. This amount of medicine may be contained in 1 mL or in one-half (0.5) mL of the injection, depending on the strength. Some people who do not need more than one injection may receive one dose of 60 mg, injected into a muscle.

Children up to 16 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Do not refrigerate. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Warnings

Taking certain other medicines together with ketorolac may increase the chance of unwanted effects. The risk will depend on how much of each medicine you take every day, and on how long you take the medicines together. 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. 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:

Aspirin or other salicylates

Diclofenac (e.g., Voltaren®)

Diflunisal (e.g., Dolobid®)

Etodolac (e.g., Lodine®)

Fenoprofen (e.g., Nalfon®)

Floctafenine (e.g., Idarac®)

Flurbiprofen (e.g., Ansaid®)

Ibuprofen (e.g., Motrin®)

Indomethacin (e.g., Indocin®)

Ketoprofen (e.g., Orudis®)

Meclofenamate (e.g., Meclomen®)

Mefenamic acid (e.g., Ponstel®)

Nabumetone (e.g., Relafen®)

Naproxen (e.g., Naprosyn®)

Oxaprozin (e.g., Daypro®)

Phenylbutazone (e.g., Butazolidin®)

Piroxicam (e.g., Feldene®)

Sulindac (e.g., Clinoril®)

Tenoxicam (e.g., Mobiflex®)

Tiaprofenic acid (e.g., Surgam®)

Tolmetin (e.g., Tolectin®)

Zomepirac (e.g., Zomax®)

Ketorolac may cause some people to become dizzy or drowsy. 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.

Serious side effects can occur during treatment with this medicine. Sometimes serious side effects can occur without any warning. 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. 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. Stop taking this medicine and check with your doctor immediately if you notice any of these warning signs.

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