Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) that contains ketorolac tromethamine, a substance with strong anti-inflammatory and pain-relieving properties. It is prescribed to relieve acute, moderate, or severe pain caused by fractures, kidney stones, or after surgery.

This medication is available in pharmacies as sublingual tablets or oral drops and should only be used with medical guidance and prescription.

Ketorolac is also available in injectable form, given directly into a vein or muscle by a nurse or trained healthcare professional. The injectable version is used only in hospitals under medical supervision.

How ketorolac works

Ketorolac belongs to a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). It works by blocking enzymes known as cyclooxygenase, or COX enzymes. These enzymes are responsible for making prostaglandins, substances in the body that cause pain, swelling, and fever. By reducing prostaglandin production, ketorolac helps relieve pain and inflammation.

Research shows that ketorolac is effective for short-term relief of moderate to severe pain, especially after surgery. Clinical trials and reviews confirm that it works as well as some opioid medications for certain types of pain, but without the same risk of addiction. However, because of its safety profile, ketorolac should only be used for a short period of time.

What it is used for

Ketorolac may be prescribed to relieve pain and inflammation in cases such as:

Postoperative pain after gallbladder removal, gynecological, or orthopedic surgeries
Fractures
Kidney stones (renal colic)
Gallbladder colic
Lower back pain
Severe toothache or pain after dental surgery
Soft tissue injuries

In addition, a doctor may recommend ketorolac in other situations involving severe pain.

Dosage and how to take

The way ketorolac is used depends on the form prescribed:

1. Sublingual tablet 10 mg

The sublingual tablet should be placed under the tongue without chewing, allowing it to dissolve completely. It should not be taken with water.

The recommended dose is determined by a doctor:

Adults up to 65 years: 10 to 20 mg (1 to 2 tablets of 10 mg) as a single dose, or 10 mg every 6 to 8 hours. The maximum daily dose is 60 mg.
Adults over 65 years, weighing less than 110 lb (50 kg), or with kidney problems: 10 to 20 mg (1 to 2 tablets of 10 mg) as a single dose, or 10 mg every 6 to 8 hours. The maximum daily dose is 40 mg.

Treatment should not last longer than 5 days.

2. Oral drops 20 mg/mL

Each mL of ketorolac oral solution contains 20 mg of ketorolac tromethamine and should be taken by mouth at the times prescribed by a doctor.

Recommended dose: 10 to 20 drops as a single dose, or 10 drops every 6 to 8 hours. The maximum daily dose is 60 drops.
For adults over 65 years, weighing less than 110 lb (50 kg), or with kidney impairment, the maximum daily dose should not exceed 40 drops.

3. Injectable ketorolac 30 mg/mL

Injectable ketorolac is administered intravenously (into a vein) or intramuscularly (into a muscle) by a trained healthcare professional, always under medical supervision.

Recommended doses:

Adults under 65 years:
- Single dose: 10 to 60 mg intramuscularly, or 10 to 30 mg intravenously
- Multiple doses: 10 to 30 mg intramuscularly every 4 to 6 hours, or 10 to 30 mg intravenously as a bolus. Maximum daily dose: 90 mg.
Adults over 65 years or with kidney impairment:
- Single dose: 10 to 30 mg intramuscularly, or 10 to 15 mg intravenously
- Multiple doses: 10 to 15 mg intramuscularly every 4 to 6 hours, or 10 to 15 mg intravenously every 6 hours. Maximum daily dose: 60 mg for older adults, 45 mg for people with kidney impairment.
Children over 2 years:
- Single or multiple doses: 1 mg/kg intramuscularly, or 0.5 to 1 mg/kg intravenously.

Injectable ketorolac should not be used for more than 2 days to reduce the risk of side effects.

Possible side effects

The most common side effects of ketorolac include headache, dizziness, drowsiness, nausea, indigestion, stomach or abdominal pain, diarrhea, increased sweating, or swelling (especially with injectable use).

Who should not use it

Ketorolac should not be used by pregnant or breastfeeding women, or by people with:

Stomach or duodenal ulcers
Gastrointestinal bleeding
Hemophilia or other blood clotting disorders
History of heart disease, heart attack, stroke, or cardiovascular conditions
Recent coronary artery bypass surgery
Surgeries with a high risk of bleeding
Severe asthma or bronchospasm
Severe kidney disease
Nasal polyps
Ulcerative colitis

It should also not be used by smokers and is not recommended for pain prevention before or during surgery because it affects platelet function and increases the risk of bleeding.

Ketorolac: How It Works, What It's Used for, Dosage & Side Effects