Ketorolac (Into the nose)
Ketorolac Tromethamine (kee-toe-ROLE-ak troe-METH-a-meen)
Relieves moderate to moderately severe pain. This medicine is a nonsteroidal anti-inflammatory drug (NSAID).
There may be other brand names for this medicine.
When This Medicine Should Not Be Used
You should not use this medicine if you have had an allergic reaction to ketorolac (Acular®, Acuvail®, or Toradol®), or ethylenediamine tetraacetic acid (EDTA). You should not use this medicine if you have a history of aspirin-sensitive asthma or aspirin sensitivity or if you have had allergic reactions to other NSAIDs (such as diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Ecotrin®, Motrin®, or Voltaren®). You should not use this medicine if you have severe kidney disease, a stomach ulcer, a bleeding disorder, or if you are pregnant or breastfeeding. Do not use this medicine right before a major surgery or right before or after having a coronary artery bypass graft (CABG), a type of heart surgery. You should not use this medicine if you are also using pentoxifylline (Trental®) or probenecid (Benemid®).
How to Use This Medicine
- Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
- This medicine is for use only in the nose. Do not get any of it in your eyes or on your skin. If it does get on these areas, rinse it off right away.
- If you are using the nasal spray for the first time, you will need to prime the spray. To do this, pump the bottle five times until some of the medicine sprays out.
- Before using the medicine, gently blow your nose to clear the nostrils.
- After using the nasal spray, wipe the tip of the bottle with a clean tissue and put the cap back on.
- This medicine is not for long-term use. Do not use it for more than 5 days in a row. The total number of days also includes any doses of ketorolac that may be given in a hospital or clinic setting. This will help lower the risk for side effects.
- Drink extra fluids so you will pass more urine while you are using this medicine. This will keep your kidneys working well and help prevent kidney problems.
- This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
If a dose is missed:
- If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
How to Store and Dispose of This Medicine
- Keep the unopened bottle in the refrigerator. Protect it from light and freezing. Once opened, store the bottle at room temperature, away from heat and direct sunlight. Throw away any unused medicine 24 hours after you opened the bottle and used your first dose.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Do not use any other forms of ketorolac (such as injection or tablets) or other NSAIDs unless your doctor says it is okay. Some other NSAIDs are aspirin, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Ecotrin®, Motrin®, or Voltaren®.
- Make sure your doctor knows if you are also using a blood thinner (such as heparin, warfarin, or Coumadin®) or a steroid medicine (such as cortisone, dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone, or Orapred®). Tell your doctor if you are using a diuretic or "water pill" (such as furosemide, hydrochlorothiazide [HCTZ], torsemide, Demadex®, or Lasix®), or certain blood pressure medicines (such as enalapril, lisinopril, losartan, Accupril®, Atacand®, Cozaar®, Diovan®, Hyzaar® Lotensin®, Lotrel®, Monopril®, Prinivil®, Vasotec®, or Zestril®).
- Make sure your doctor knows if you are also using lithium (Eskalith®), methotrexate (Folex®, Rheumatrex®), thiothixene (Navane®), alprazolam (Xanax®), fluoxetine (Prozac®), or medicine for seizures (such as carbamazepine, phenytoin, Dilantin®, or Tegretol®).
Warnings While Using This Medicine
- Make sure your doctor knows if you have a history of ulcers or other stomach problems. Tell your doctor if you have kidney disease, liver disease, anemia, Crohn's disease, ulcerative colitis, high blood pressure, congestive heart failure (CHF), or other heart or circulation problems.
- This medicine may cause bleeding in your stomach or intestines. This problem can happen without warning signs. This is more likely if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, if you are over 60 years of age, are in poor health, or are using certain other medicines (such as steroids or a blood thinner). Stop using this medicine and call your doctor right away if you have bloody or black, tarry stools; severe stomach pain or heartburn; or vomiting of blood or material that looks like coffee grounds.
- This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth while you are using this medicine.
- This medicine may increase your risk of having a heart attack. This is more likely in people who already have heart disease. Stop using this medicine and call your doctor right away if you have chest pain or discomfort; an irregular or fast heart beat; severe indigestion or heartburn; nausea; sweating; or troubled breathing with exertion.
- Serious skin reactions can occur during treatment with this medicine. Stop using this medicine and check with your doctor right away if you have any of the following symptoms while you are using this medicine: blistering, peeling, loosening of the skin; chills; cough; diarrhea; fever; itching; joint or muscle pain; red skin lesions; sore throat; sores, ulcers, or white spots in the mouth or on the lips; or unusual tiredness or weakness.
- Check with your doctor right away if you have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.
- Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
- Blistering, peeling, or red skin rash.
- Bloody, black or tarry stools.
- Blurred vision or changes in vision.
- Change in how much or how often you urinate.
- Chest pain, shortness of breath, or coughing up blood.
- Dark-colored urine or pale stools.
- Nausea, vomiting, loss of appetite, or pain in your upper stomach.
- Numbness or weakness in your arm or leg, or on one side of your body.
- Pain in your lower leg (calf).
- Problems with vision, speech, or walking.
- Rapid weight gain.
- Shortness of breath, cold sweats, and bluish-colored skin.
- Swelling in your hands, ankles, or feet.
- Unusual bleeding, bruising, or weakness.
- Vomiting of blood or something that looks like coffee grounds.
- Yellowing of your skin or the whites of your eyes.
If you notice these less serious side effects, talk with your doctor:
- Constipation, diarrhea, heartburn, stomach pain, or upset stomach.
- Dizziness or drowsiness.
- Feeling of discomfort in your nose.
- Mild rash or itching skin.
- Ringing in your ears.
If you notice other side effects that you think are caused by this medicine, tell your doctor
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088
Review Date: 2011-02-04
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