Ketorolac Injection

What is this medication?

KETOROLAC (kee toe ROLE ak) treats short-term moderate to severe pain. It works by decreasing inflammation. It belongs to a group of medications called NSAIDs.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Toradol

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Bleeding disorder
• Coronary artery bypass graft (CABG) within the past 2 weeks
• Heart attack
• Heart disease
• Heart failure
• High blood pressure
• If you often drink alcohol
• Kidney disease
• Liver disease
• Lung or breathing disease, such as asthma or COPD
• Receiving steroids like dexamethasone or prednisone
• Smoke tobacco cigarettes
• Stomach bleeding
• Stomach ulcers, other stomach or intestine problems
• Take medication to treat or prevent blood clots
• An unusual or allergic reaction to ketorolac, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is injected into a vein or muscle. It is given in a hospital or clinic setting.

A special MedGuide will be given to you before each treatment. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. Special care may be needed.

Patients over 65 years of age may have a stronger reaction and need a smaller dose.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

This does not apply. This medication is not for regular use.

What may interact with this medication?

Do not take this medication with any of the following:

• Aspirin and aspirin-like medications
• Cidofovir
• Methotrexate
• NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
• Pentoxifylline
• Probenecid

This medication may also interact with the following:

• Alcohol
• Alendronate
• Alprazolam
• Carbamazepine
• Diuretics
• Flavocoxid
• Fluoxetine
• Ginkgo
• lithium
• Medications for blood pressure like enalapril
• Medications that affect platelets like pentoxifylline
• Medications that treat or prevent blood clots like heparin, warfarin
• Muscle relaxants
• Pemetrexed
• Phenytoin
• Thiothixene

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Your condition will be monitored carefully while you are receiving this medication.

Do not use this medication for more than 5 days. It is only used for short-term treatment of moderate to severe pain. The risk of side effects such as kidney damage and stomach bleeding are higher if used for more than 5 days.

Do not take other medications that contain aspirin, ibuprofen, or naproxen with this medication. Side effects such as stomach upset, nausea, or ulcers may be more likely to occur. Many non-prescription medications contain aspirin, ibuprofen, or naproxen. Always read labels carefully.

This medication can cause serious ulcers and bleeding in the stomach. It can happen with no warning. Smoking, drinking alcohol, older age, and poor health can also increase risks. Call your care team right away if you have stomach pain or blood in your vomit or stool.

Alcohol may interfere with the effect of this medication. Avoid alcoholic drinks.

This medication may cause serious skin reactions. They can happen weeks to months after starting the medication. Contact your care team right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips or lymph nodes in your neck or under your arms.

Talk to your care team if you are pregnant before taking this medication. Taking this medication between weeks 20 and 30 of pregnancy may harm your unborn baby. Your care team will monitor you closely if you need to take it. After 30 weeks of pregnancy, do not take this medication.

This medication does not prevent a heart attack or stroke. This medication may increase the chance of a heart attack or stroke. The chance may increase the longer you use this medication or if you have heart disease. If you take aspirin to prevent a heart attack or stroke, talk to your care team about using this medication.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medication affects you. Do not stand up or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
• Heart failure—shortness of breath, swelling of ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
• Increase in blood pressure
• Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
• Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
• Low red blood cell count—unusual weakness or fatigue, dizziness, headache, trouble breathing
• Rash, fever, and swollen lymph nodes
• Redness, blistering, peeling, or loosening of the skin, including inside the mouth
• Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds
• Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Constipation
• Diarrhea
• Dizziness
• Headache
• Nausea
• Stomach pain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

This medication is given in a hospital or clinic. It will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.