Toradol (Ketorolac)

Name	Toradol (Ketorolac)
Uses	Nonsteroidal anti-inflammatory drug (NSAID) used for short-term relief of moderate to severe pain. In wellness settings, it may be used for acute pain relief, such as post-exercise soreness, headache relief, or general musculoskeletal discomfort. Routine use in elective wellness protocols is not recommended.
Route Of Administration	Intravenous (IV)
Frequency Of Use	Administered as needed for acute pain relief. Should not be used more than once in a 24-hour period and not more than 5 consecutive days in elective wellness settings.
Concentration(s)	Common concentration: 15 mg/mL or 30 mg/mL.
Maximum Dosage (Day, Wk) (g/mL)/mL	Maximum dose per infusion: 30 mg IV. Maximum daily dose: 30 mg IV. Maximum treatment duration: 5 days. Extended use in wellness patients is not recommended due to gastrointestinal, renal, and cardiovascular risks.
Contraindications	Active peptic ulcer disease. Recent gastrointestinal bleeding. Severe renal impairment. History of NSAID-induced asthma or allergic reaction. Pregnancy (third trimester). Breastfeeding unless cleared by OB provider. Known hypersensitivity to ketorolac or other NSAIDs. Patients with coagulation disorders or on anticoagulant therapy should avoid use.
Possible Side Effects	Nausea, dizziness, headache, or gastrointestinal discomfort during or after infusion. Increased risk of bleeding, particularly in higher doses. Injection site irritation. Rare: allergic reaction (rash, itching, anaphylaxis). Prolonged use increases risk of gastrointestinal ulcers, kidney injury, and cardiovascular events.
Compatibility With Other Drugs	Compatible with normal saline and D5W. Should not be mixed directly with other NSAIDs, anticoagulants, or corticosteroids. Always verify compatibility if combining with other nutrients.
Allergies	True allergy to ketorolac is rare but possible. Cross-reactivity with other NSAIDs can occur.
Administration Time	Typical administration time: Slow IV push over at least 15 seconds. May also be diluted and infused over 15 to 30 minutes if needed for better tolerability.
IV Dosing	Single dose for acute pain: 15 mg to 30 mg IV as needed. Maximum duration: 5 consecutive days. Patients should be counseled on risks with repeat use.
IM/Push	May be given as a slow IV push over at least 15 seconds. IM administration is also acceptable but may cause more local irritation.
What To Do If Adverse Reaction Occurs	1. Stop the infusion immediately if a reaction occurs. 2. Assess vital signs (blood pressure, heart rate, oxygen saturation). 3. If nausea, dizziness, or gastrointestinal discomfort occurs, place the patient in a comfortable position and provide oral fluids if tolerated. 4. For allergic reactions (rash, itching, shortness of breath), administer antihistamines and consider epinephrine if severe. 5. If gastrointestinal bleeding is suspected (severe abdominal pain, vomiting blood, black stools), arrange for emergency transfer to a higher level of care (call 911 if necessary).