Ketorolac tromethamine tablets, a non-steroidal anti-inflammatory drug (NSAID), are indicated for the short-term (up to 5 days in adults), 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. The total combined duration of use of ketorolac tromethamine should not exceed 5 days.
Ketorolac tromethamine tablets are not indicated for use in pediatric patients and it is NOT indicated for minor or chronic painful conditions. Increasing the dose of ketorolac tromethamine tablets beyond a daily maximum of 40 mg in adults will not provide better efficacy but will increase the risk of developing serious adverse events.
•Ketorolac tromethamine can cause peptic ulcers, gastrointestinal bleeding and/or perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Therefore, ketorolac tromethamine is CONTRAINDICATED in patients with active peptic ulcer disease, in patients with recent gastrointestinal bleeding or perforation, and in patients with a history of peptic ulcer disease or gastrointestinal bleeding. Elderly patients are at greater risk for serious gastrointestinal events (see WARNINGS).
•NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk (see WARNINGS and CLINICAL STUDIES).
•Ketorolac tromethamine is CONTRAINDICATED for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery (see WARNINGS).
•Ketorolac tromethamine is CONTRAINDICATED in patients with advanced renal impairment and in patients at risk for renal failure due to volume depletion (see WARNINGS).
RISK OF BLEEDING
•Ketorolac tromethamine inhibits platelet function and is, therefore, CONTRAINDICATED in patients with suspected or confirmed cerebrovascular bleeding, patients with hemorrhagic diathesis, incomplete hemostasis and those at high risk of bleeding (see WARNINGS
Ketorolac tromethamine is CONTRAINDICATED as prophylactic analgesic before any major surgery.
RISK DURING LABOR AND DELIVERY
•The use of ketorolac tromethamine in labor and delivery is contraindicated because it may adversely affect fetal circulation and inhibit uterine contractions.
CONCOMITANT USE WITH NSAIDS
•Ketorolac tromethamine is CONTRAINDICATED in patients currently receiving aspirin or NSAIDs because of the cumulative risk of inducing serious NSAID-related side effects.
•Dosage should be adjusted for patients 65 years or older, for patients under 50 kg (110 lbs) of body weight (see DOSAGE AND ADMINISTRATION) and for patients with moderately elevated serum creatinine (see WARNINGS).
Ketorolac tromethamine is a member of the pyrrolo-pyrrole group of non-steroidal anti-inflammatory drugs (NSAIDs).
Carefully consider the potential benefits and risks of ketorolac tromethamine tablets and other treatment options before deciding to use ketorolac tromethamine tablets. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
Acute Pain in Adult Patients
Ketorolac tromethamine tablets are indicated for the short-term (≤ 5 days) management of moderately severe acute pain that requires analgesia at the opioid level, usually in a postoperative setting. Therapy should always be initiated with ketorolac tromethamine-IV or IM and ketorolac tromethamine tablets are to be used only as continuation treatment, if necessary.
The total combined duration of use of ketorolac tromethamine-IV/IM and ketorolac tromethamine tablets is not to exceed 5 days of use because of the potential of increasing the frequency and severity of adverse reactions associated with the recommended doses (see WARNINGS, PRECAUTIONS, DOSAGE AND ADMINISTRATION and ADVERSE REACTIONS). Patients should be switched to alternative analgesics as soon as possible, but ketorolac tromethamine tablet therapy is not to exceed 5 days
Media Articles Related to Ketorolac (Ketorolac Tromethamine)
Pediatric Pain Management
Source: Medscape Critical Care Headlines [2016.04.29]
What can be done to improve nurses' assessment and management of children's pain?
Friday Feedback: The Continuing Problem of Opioids and Pain
Source: MedPageToday.com - medical news plus CME for physicians [2016.04.29]
(MedPage Today) -- Can the FDA find a solution?
Friends better than morphine: Larger social networks release more pain-killing endorphin
Source: Anxiety / Stress News From Medical News Today [2016.04.28]
People with more friends have higher pain tolerance, Oxford University researchers have found.
How is the Federal Government's Pain Strategy Faring?
Source: MedPage Today Rheumatology [2016.04.26]
(MedPage Today) -- It's well-intentioned, but something is lacking, says Kenneth Lin, MD
Psychological issues behind increasing low back pain
Source: Psychology / Psychiatry News From Medical News Today [2016.04.25]
Low back pain is the most common symptom seen in primary care; the underlining injury is often enhanced by psychological and social stressors, write the authors of a Perspective published online by...
Published Studies Related to Ketorolac (Ketorolac Tromethamine)
Ketorolac does not increase perioperative bleeding: a meta-analysis of randomized
controlled trials. 
postoperatively, but concerns over postoperative bleeding have limited its use... CONCLUSIONS: This is the first meta-analysis of randomized controlled trials
Intramuscular ketorolac versus oral ibuprofen for pain relief in first-trimester
surgical abortion: a randomized clinical trial. 
ketorolac for pain management during first-trimester surgical abortion... CONCLUSIONS: Intramuscular ketorolac does not offer superior pain control
Prophylactic nepafenac and ketorolac versus placebo in preventing postoperative
macular edema after uneventful phacoemulsification. 
randomized clinical trial... CONCLUSIONS: One month after uneventful phacoemulsification, there was no
The effect of perioperative ketorolac on pain control in pregnancy termination. [2011.11.29]
BACKGROUND: The study was conducted to evaluate the effect of perioperative ketorolac on pain associated with first-trimester aspiration abortion... CONCLUSION: Perioperative ketorolac has the same effect on postoperative pain as determined by VAS as placebo. The use of ketorolac at the 30-mg dose cannot be recommended for better pain control for patients undergoing first-trimester pregnancy termination by suction curettage. The only positive effect of the use of ketorolac compared to placebo was a reduction in the use of acetaminophen. Ketorolac use does not appear to change blood loss in the operating room or through postoperative day 1 compared to placebo. Copyright (c) 2011 Elsevier Inc. All rights reserved.
A randomized, controlled trial validates a peripheral supra-additive antihyperalgesic effect of a paracetamol-ketorolac combination. [2011.11]
The combination of paracetamol with non-steroidal anti-inflammatory drugs (NSAIDs) is widely used; however, the nature and mechanism of their interaction are still debated. A double-blind, pharmacokinetic/pharmacodynamic, randomized, cross-over, placebo-controlled study was carried out in human healthy volunteers...
Clinical Trials Related to Ketorolac (Ketorolac Tromethamine)
Ketorolac in Postoperative Infants: Pharmacokinetics and Safety [Completed]
Infants handle ketorolac differently than adults. Study of handling of this pain medication
given to infants following surgery. Detailed analysis of how the drug is eliminated from age
2 months to 18 months. Compared morphine use in infants who received the drug to the group
getting placebo. Safety testing for kidney and liver function, breathing measured by
continuous oximetry, and any bleeding issues.
Pharmacokinetics of Intranasal Ketorolac in Children [Recruiting]
Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) that is typically given to both
adults and children by the intravenous (IV) or intramuscular (IM) route for analgesic
purposes. Ketorolac can also be given by the intranasal (IN) route using a mucosal
atomization device (MAD). We aim to study the pharmacokinetics of ketorolac when
administered by the IN route using the MAD.
Availability & Effect of Post-OP Ketorolac on Ovarian, Fallopian Tube or Primary Peritoneal Cancer [Recruiting]
A Pilot Study Comparing the Analgesic Efficacy of IV Ibuprofen and IV Ketorolac [Enrolling by invitation]
Evaluation of GTPase Inhibition by Post-operative Intravenous Ketorolac in Ovarian Cancer Patients [Not yet recruiting]
There is a move towards personalized medicine in cancer care, and significant effort is
underway to evaluate new targeted therapeutics for the treatment of ovarian cancer. One way
to identify potential new drug targets is by screening a drug library to determine whether
drugs in the library target key kinase or enzymatic sites in cellular signaling pathways.
Previous preclinical work and pilot studies demonstrated that ketorolac (a type of
non-steroidal anti-inflammatory drug) inhibits GTPase activity in ovarian cancer cells
retrieved from the post-operative peritoneal cavity.
The purpose of this study is to confirm that this inhibitory effect is ketorolac driven and
not a specific effect of the post-operative peritoneal compartment.
PATIENT REVIEWS / RATINGS / COMMENTS
Based on a total of 1 ratings/reviews, Ketorolac has an overall score of 7. The effectiveness score is 8 and the side effect score is 10. The scores are on ten point scale: 10 - best, 1 - worst.
Ketorolac review by 45 year old female patient
|Overall rating:|| || |
|Effectiveness:|| || Considerably Effective|
|Side effects:|| || No Side Effects|
|Condition / reason:|| || pain, muscle strain|
|Dosage & duration:|| || 1 tablet taken as needed, maybe once per week or month for the period of several years|
|Other conditions:|| || none|
|Other drugs taken:|| || none|
|Benefits:|| || This works very well for mild to moderate pain, usually caused by over-exertion, and charaterized by muscle soreness, spasms, cramps, tightness|
|Side effects:|| || I did not personally have any problems with this medication, though like with any NSAID, stomach upset and liver damage certainly have to be considered.|
|Comments:|| || I just use this off and on for anytime i have pain and spasms most generally associated with over - exertion|
Page last updated: 2016-04-29