Ketorolac, Oral/Injection KEE-toh-rol-ak

What are other names for this medicine?

Type of medicine: nonsteroidal anti-inflammatory drug (NSAID); analgesic (pain medicine)

Generic and brand names: ketorolac, injection; ketorolac, oral; Toradol

What is this medicine used for?

This medicine is used for up to 5 days to relieve pain, usually after surgery or dental procedures. Treatment is usually started by injections (shots) and continued with tablets taken by mouth.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a stroke
• asthma
• bleeding problems or blood disorders
• heart disease or high blood pressure
• inflammatory bowel disease or Crohn’s disease
• kidney or liver disease
• trouble urinating
• ulcers or intestinal bleeding

Tell your healthcare provider if you smoke or drink alcohol. Alcohol and smoking may increase the risk of ulcers or stomach bleeding. Also tell your provider if you are taking one aspirin a day for heart disease or stroke, or if you take other medicine that reduces the chance of blood clots forming such as warfarin (Coumadin).

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not take this medicine during the 6th to 9th months of pregnancy because it can harm the baby. Do not breast-feed while you are taking or receiving injections of this medicine.

How do I use it?

The shots are given by your healthcare provider after surgery or an injury, usually while you are in a hospital, surgical clinic, or emergency room.

To prevent severe side effects, treatment with this medicine should not last longer than 5Â days. If you need pain relief after 5 days, your healthcare provider will prescribe another painkiller.

If your healthcare provider has prescribed tablets to be taken by mouth after the shots, be sure to follow the directions exactly. Take this medicine with food. Do not take more tablets than your healthcare provider prescribes. Do not take double doses, and do not take the tablets if you do not have any pain.

This is a strong medicine that can cause ulcers and other intestinal or stomach problems. Therefore, follow your healthcare provider's directions carefully. If you are not sure of the dosage or other directions, ask your healthcare provider or pharmacist to explain.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, stomach pain, drowsiness, black or bloody stools, coughing blood, decreased urination, shallow breathing, fainting, coma.

What should I watch out for?

Warning: Occasionally, this medicine may cause bleeding, ulcers, or perforation of the stomach, small intestine, or large intestine. These problems may occur with or without warning symptoms. If you have abdominal pain, a black tarry stool, or a bloody stool, stop taking this medicine and contact your healthcare provider right away.

Do not take other pain relievers or drink alcohol while you are taking this medicine without your healthcare provider's approval.

Adults over the age of 65 and people with liver or kidney disease require lower dosages of this medicine. Follow your healthcare provider's directions carefully.

This medicine may make you drowsy or dizzy. Do not drive or operate machinery until you are fully alert.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Taking this medicine for a long time will make it more likely that you will have a heart attack or stroke. Talk with your healthcare provider about this.

This medicine may cause an allergic reaction in people who have asthma or who have had an allergic reaction to aspirin or other pain killers. If you develop hives, itching, a rash, tightness in your chest, or trouble breathing, stop taking this medicine and contact your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you are unable to reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives, itching, rash, tightness in your chest, trouble breathing).

Serious (report these to your healthcare provider right away): Severe drowsiness; severe nausea or vomiting; stomach pain; tarry or bloody stools; swelling of hands, feet, ankles, or legs, or any unexplained swelling; unusual weakness or tiredness; severe skin rash or blisters; unusual bleeding or bruising; blood in the urine or trouble urinating.

Other: Pain where the injection was given, indigestion, nausea, vomiting, constipation, diarrhea, headache, dizziness, sweating, nervousness, depression.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), lisinopril (Prinivil), and quinapril (Accupril)
• alprazolam (Xanax)
• angiotensin receptor II blockers such as candesartan (Atacand), irbesartan (Avapro), losartan (Cozaar), and valsartan (Diovan)
• antibiotics such as ciprofloxacin (Cipro), levofloxacin (Levaquin), and ofloxacin (Floxin)
• antidepressants such as amitriptyline, bupropion (Wellbutrin), doxepin, duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox CR), imipramine (Tofranil), nefazodone, nortriptyline (Pamelor), paroxetine (Paxil), sertraline (Zoloft), trazodone, and venlafaxine (Effexor)
• antiseizure medicine such as carbamazepine (Tegretol) and phenytoin (Dilantin)
• aspirin and other salicylates
• beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Normodyne, Trandate), and metoprolol (Lopressor, Toprol)
• cholestyramine (Questran, Questran Light)
• clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), heparin, and warfarin (Coumadin)
• corticosteroids such as cortisone, dexamethasone, hydrocortisone (Hydrocortone, Cortef), methylprednisolone (Medrol), prednisolone (Pediapred, Prelone), prednisone (Liquid Pred, Prednisone Intensol), and triamcinolone (Aristospan, Kenalog)
• dasatinib (Sprycel)
• diuretics such as amiloride, bumetanide, chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide, spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• lithium (Lithobid)
• medicines to treat or prevent blood clots such as
• methotrexate
• natural remedies such as alfalfa, anise, bilberry, cat’s claw, celery, chamomile, dong quai, evening primrose oil, fenugreek, feverfew, garlic, glucosamine, ginkgo biloba, ginger, ginseng, green tea, horse chestnut seed, licorice, red clover, SAMe, and sweet clover
• other nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• pentoxifylline (Trental)
• probenecid (Benemid)
• thiothixene (Navane)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicines in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.