Ketorolac is used for the short-term relief of moderate to moderately severe pain and should not be used for longer than 5 days in a row, for mild pain, or for pain from chronic (long-term) conditions. You may be given ketorolac to take by mouth or as an injection before you begin using ketorolac nasal spray. You must stop using nasal ketorolac on the fifth day after you receive your first dose of ketorolac in any form. Talk to your doctor if you still have pain after 5 days of treatment with ketorolac.
Ketorolac nasal spray should not be used to relieve pain in children 17 years of age or younger.
People who use nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as ketorolac may have a higher risk of having a heart attack or a stroke than people who do not use these medications. These events may happen without warning and may cause death. This risk may be higher for people who use NSAIDs for a long time. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke or 'ministroke;' if you smoke; and if you have or have ever had high cholesterol, high blood pressure, bleeding or clotting problems, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, numbness or weakness in one part or side of the body, trouble seeing in one or both eyes, trouble walking or loss of balance or coordination, severe headache with no known cause, or slurred speech.
If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not use ketorolac right before or right after the surgery.
NSAIDs such as ketorolac may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older than 65 years of age, have poor health, drink alcohol, or smoke while using ketorolac. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin; or oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); or selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). Do not take aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) or any other forms of ketorolac while you are using ketorolac nasal spray. Also tell your doctor if you have or have ever had ulcers or bleeding in your stomach or intestines. If you experience any of the following symptoms, stop using ketorolac and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.
Ketorolac may cause an increased risk of bleeding. It may take longer than usual for you to stop bleeding if you are cut or injured. Tell your doctor if you have or have ever had a bleeding disorder, or bleeding in your brain. Your doctor will probably tell you not to use ketorolac nasal spray. Call your doctor if you have bleeding that is unusual or if you fall and get hurt, especially if you hit your head.
Ketorolac may cause kidney failure. Tell your doctor if you have kidney or liver disease, if you have had severe vomiting or diarrhea or think you may be dehydrated, and if you are taking angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); angiotensin II receptor blockers such as azilsartan (Edarbi), candesartan(Atacand), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor), telmisartan (Micardis), and valsartan (Diovan, in Exforge); or diuretics ('water pills'). If you experience any of the following symptoms, stop using ketorolac and call your doctor: swelling of the hands, arms, feet, ankles, or lower legs; unexplained weight gain; decreased urination, confusion; or seizures.
Keep all appointments with your doctor. Be sure to tell your doctor how you are feeling so that your doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with ketorolac. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( Web Site) to obtain the Medication Guide.
Talk to your doctor about the risks of using ketorolac nasal spray.
HOW should this medicine be used?
Nasal ketorolac comes as a liquid to spray in the nose. It is usually used once every 6 to 8 hours as needed to control pain for up to 5 days. Use ketorolac nasal spray exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Ketorolac nasal spray comes in bottles that each contain a one-day supply of medication. Do not use any single bottle of ketorolac nasal spray for more than one day. Throw away the bottle within 24 hours of using the first dose, even if the bottle still contains some medication. You will receive enough bottles of medication so that you have a new bottle to use for each day of treatment.
Before you use ketorolac nasal spray for the first time, read the written instructions that come with the medication. Be sure that you understand how to prepare the bottle before the first use and how to use the spray. Ask your doctor or pharmacist if you have any questions about how to use this medication.
Ketorolac nasal spray is only for use in the nose. Be careful not to get the medication in your eyes. If you do get ketorolac nasal spray in your eye, wash out the eye with water or sterile saline solution and call your doctor if irritation lasts longer than an hour.
You may have an uncomfortable feeling in your throat after you use ketorolac nasal spray. If this happens, drink a sip of water.