Adult Dosing
Short-term management of moderately severe, acute pain
Single dose therapy
- <65 yrs: 60 mg IM x1 or 30 mg IV x1
- If >65 yrs or <50 kgs: 30 mg IM x1 or 15 mg IV x1
Multiple dose therapy
- <65 yrs: 30 mg IV/IM q6 hrs. Max: 120 mg/day
- If >65 yrs or <50 kgs: 15 mg IV/IM q6 hrs. Max: 60 mg/day
Pediatric Dosing
Short-term management of moderately severe, acute pain
Single dose therapy
- >2 yrs: 30 mg IM x 1. or 15 mg IV x 1
- >6 months (Not FDA approved)
- 0.5 mg/kg IM/IV q6 hrs up to 72 hrs
- Alt: 1 mg/kg IM/IV q6 hrs up to 24-48 hrs
- Max: 30 mg/dose IM, 15 mg/dose IV
[Outline]
- Carefully consider the potential benefits and risks of ketorolac tromethamine and other treatment options before starting therapy
- Use the lowest effective dose for the shortest duration
- In adults, the combined duration of use of all formulations must not exceed 5 days
- Hypersensitivity reactions may occur; use with caution in aspirin-sensitive individuals because of possible cross-sensitivity
- Fluid retention and edema have been reported with ketorolac. Use cautiously in patients with cardiac decompensation, hypertension, or other similar conditions
- The risk of serious cardiovascular events & GI bleeding may be increased in patients taking long-term, high-dose NSAIDs; use lowest effective dose to obtain desired results
- To minimize the potential risk for an adverse GI event, the lowest effective dose should be used for the shortest possible duration
- Patients on therapeutic doses of anticoagulants (e.g., heparin) have an increased risk of bleeding events if given ketorolac tromethamine concurrently
- Long-term administration of NSAIDs may cause renal papillary necrosis. Use with caution in renal function, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors
- Monitor serum creatinine at baseline and then periodically if severe renal disease
Cautions: Use cautiously in
- Hepatic impairment
- Renal impairment, mild-moderate
- Smoker
- Asthma
- Hypertension
- Cardiovascular disease
- Cardiac risk factors
- Inflammatory bowel disease
- Concurrent diuretics
- ACE inhibitor or ARB use
- CHF
- Anticoagulant use
- Coagulation disorder
- Corticosteroid use
- Alcohol use
Pregnancy Category:C ( D in third trimester)
Breastfeeding: Contraindicated
