Safety of 60 mg Toradol (Ketorolac) for Initial Pain Management

Dosing Guidelines for Ketorolac

• 60 mg IM is an established initial dose for acute pain management according to clinical guidelines 1
• The dosing interval should be every 15-30 minutes as needed for pain control 1
• Maximum daily dose should not exceed 120 mg 1
• Total duration of treatment must not exceed 5 days 1, 2

Patient Selection and Contraindications

• The American Academy of Family Physicians recommends avoiding ketorolac in patients with aspirin/NSAID-induced asthma 1
• The American Academy of Family Physicians recommends avoiding ketorolac in pregnant patients 1
• The American Academy of Family Physicians recommends avoiding ketorolac in patients with cerebrovascular hemorrhage 1

Potential Adverse Effects

• Edema is a common side effect of ketorolac 1
• Drowsiness is a common side effect of ketorolac 1
• Dizziness is a common side effect of ketorolac 1
• Gastrointestinal upset is a common side effect of ketorolac 1
• Increased diaphoresis (sweating) is a common side effect of ketorolac 1

Clinical Pearls

• For pediatric patients, the recommended intraoperative single dose of ketorolac is 0.5-1 mg/kg 3

Post-Operative Pain Management with Injectable Ketorolac

Safety Precautions

• Do not use injectable ketorolac with curative doses of anticoagulants, as recommended by the Anaesthesia guideline society 4

Transition Plan

• Consider multimodal analgesia approaches, including paracetamol (acetaminophen) and, if appropriate, weak opioids, as suggested by the Anaesthesia guideline society 5