ketorolac (oral/injection)

What is the most important information I should know about ketorolac?

Ketorolac can increase your risk of fatal heart attack or stroke. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Ketorolac may also cause stomach or intestinal bleeding, which can be fatal.

You should not use ketorolac if you also take pentoxifylline, probenecid, aspirin, or other NSAIDs.

What is ketorolac?

Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that is used short-term (5 days or less) to treat moderate to severe pain.

Ketorolac may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking ketorolac?

Ketorolac can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ketorolac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ketorolac, especially in older adults.

• active or recent stomach ulcer, stomach bleeding, or intestinal bleeding;
• a bleeding or blood-clotting disorder;
• a closed head injury or bleeding in your brain;
• bleeding from a recent surgery;
• severe kidney disease or dehydration;
• a history of asthma or severe allergic reaction after taking aspirin or an NSAID;
• if you are scheduled to have surgery (especially bypass surgery); or
• if you are in late pregnancy or you are breast-feeding a baby.

Some medicines can cause unwanted or dangerous effects when used with ketorolac. Your doctor may need to change your treatment plan if you use any of the following drugs:

• pentoxifylline;
• probenecid; or
• aspirin or other NSAIDs --ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

Tell your doctor if you have ever had:

• heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;
• a heart attack, stroke, or blood clot;
• stomach ulcers or bleeding;
• inflammatory bowel disease, ulcerative colitis, or Crohn's disease;
• liver disease;
• kidney disease (or if you are on dialysis);
• asthma; or
• fluid retention.

If you are pregnant, you should not take ketorolac unless your doctor tells you to. Taking an NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy.

Tell your doctor if you are breastfeeding.

How should I take ketorolac?

Follow all directions on your prescription label and read all medication guides. Use the lowest dose that is effective in treating your condition.

Ketorolac oral is taken by mouth.

Ketorolac injection is given as an infusion into a vein. A healthcare provider will give you this injection

What happens if I miss a dose?

Since ketorolac is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

What should I avoid while taking ketorolac?

What are the possible side effects of ketorolac?

• shortness of breath (even with mild exertion);
• swelling or rapid weight gain;
• a skin rash, no matter how mild;
• signs of stomach bleeding --bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• liver problems --loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• kidney problems --little or no urination, swelling in your feet or ankles, feeling tired or short of breath; o
• low red blood cells (anemia) --pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.

Common side effects may include:

• nausea, stomach pain, indigestion, diarrhea;
• dizziness, drowsiness;
• headache; or
• swelling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect ketorolac?

Tell your doctor about all your other medicines, especially:

• lithium;
• methotrexate;
• heparin or warfarin (Coumadin, Jantoven);
• antipsychotic medicine;
• heart or blood pressure medication, including a diuretic or "water pill";
• seizure medicine (carbamazepine, phenytoin); or
• steroid medicine (such as prednisone).

This list is not complete. Other drugs may affect ketorolac, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about ketorolac.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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