IV Toradol Safety During Breastfeeding

Evidence for Safety

• The Association of Anaesthetists lists ketorolac as a safe analgesic option for breastfeeding women in their 2020 guidelines 1, 2, 3
• Ketorolac can be used as part of a multimodal analgesia approach for breastfeeding women, according to the Association of Anaesthetists 1, 2

Pharmacokinetic Considerations

• The minimal transfer of ketorolac into breast milk makes it a suitable option for postoperative pain management in breastfeeding mothers 1

Clinical Recommendations

• The Association of Anaesthetists recommends ketorolac as a preferred option over opioids for breastfeeding women due to its favorable safety profile 1, 2
• Ketorolac should be used at the lowest effective dose for the shortest period of time, as recommended by the Association of Anaesthetists 1, 2

Important Caveats

• Special consideration should be given to infants less than 6 weeks of age (corrected for gestation) when using ketorolac, due to their immature hepatic and renal function 1

Ketorolac Safety During Breastfeeding

Safety Profile in Breastfeeding

• Ketorolac is transferred into breast milk in very low concentrations, making it compatible with breastfeeding 4, 5
• The American College of Anaesthesia recommends ketorolac as safe for use during breastfeeding as low levels are detected in breast milk without demonstrable adverse effects in the neonate 4

Alternative Options

• Other NSAIDs like ibuprofen and diclofenac are also considered safe during breastfeeding 4, 6
• Paracetamol (acetaminophen) is another safe alternative for pain management during breastfeeding 6

Ketorolac Use During Breastfeeding

Safety and Compatibility

• Ketorolac is safe and compatible with breastfeeding, as it passes into breast milk in very low concentrations without demonstrable adverse effects in the neonate, according to the Association of Anaesthetists 2020 guidelines 7
• The minimal transfer into breast milk makes ketorolac substantially safer than many opioid alternatives that carry risks of infant sedation and respiratory depression 7

Clinical Recommendations

• Breastfeeding can continue immediately after ketorolac administration without any waiting period, as recommended by the Association of Anaesthetists 2020 guidelines 7