ketorolac (nasal)

ketorolac (nasal)

Pronunciation: KEE toe ROLE ak

What is the most important information I should know about ketorolac nasal?

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You should not use ketorolac nasal if you are allergic to it, or if you have severe kidney disease, asthma, a bleeding or blood clotting disorder, a closed head injury or bleeding in your brain, a stomach ulcer or perforation, history of stomach or intestinal bleeding, if you are breast-feeding a baby, if you are also taking pentoxifylline (Trental) or probenecid (Benemid), or if you are allergic to aspirin or other NSAIDs (Advil, Aleve, Celebrex, Indocin, Naprosyn, Orudis, Voltaren, and others).

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This medicine may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term. Do not use ketorolac nasal just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

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This medicine may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking ketorolac nasal, especially in older adults.

Call your doctor at once if you have symptoms of stomach bleeding such as black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

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Ketorolac nasal may be harmful if you use the medication after 30 weeks of pregnancy, or during labor. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

What is ketorolac nasal?

Ketorolac nasal is a non steroidal anti inflammatory drug (NSAID). This medicine works by reducing substances in the body that cause pain, fever, and inflammation.

Ketorolac is used short-term (5 days or less) to treat moderate to severe pain.

Ketorolac may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking ketorolac nasal?

Do not use ketorolac nasal just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

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This medicine may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term.

This medicine may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking ketorolac nasal, especially in older adults.

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Do not use this medication if you are allergic to ketorolac, or if you have:

  • severe kidney disease;
  • a bleeding or blood clotting disorder;
  • asthma, or "aspirin triad syndrome," a severe allergic reaction caused by taking aspirin, or other NSAIDs (Advil, Aleve, Celebrex, Indocin, Naprosyn, Orudis, Voltaren, and others);
  • a closed head injury or bleeding in your brain;
  • a stomach ulcer, perforation, or a history of stomach or intestinal bleeding;
  • if you are breast-feeding a baby; or
  • if you are also taking pentoxifylline (Trental) or probenecid (Benemid).
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Do not use ketorolac nasal if you are already taking aspirin or other NSAIDs, or using other forms of ketorolac (such as injections or pills you take by mouth).

To make sure you can safely use ketorolac, tell your doctor if you have any of these other conditions:

  • a history of heart attack, stroke, or blood clot;
  • heart disease, congestive heart failure, high blood pressure;
  • liver or kidney disease,
  • ulcerative colitis or Crohn's disease;
  • polyps in your nose;
  • if you have recently had surgery; or
  • if you smoke.
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FDA pregnancy category D. Ketorolac nasal may be harmful to an unborn baby if the mother uses the medication after 30 weeks of pregnancy. Using ketorolac nasal during labor can increase the risk of bleeding during childbirth. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

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Ketorolac nasal can pass into breast milk and may harm a nursing baby. Do not breast feed a baby while taking this medication.

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Do not give this medicine to anyone younger than 18 years old.

How should I take ketorolac nasal?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

This medication comes with patient instructions for safe use, and directions for priming the nasal spray. Ask your doctor or pharmacist if you have any questions.

Ketorolac nasal is usually given every 6 to 8 hours. Follow your doctor's instructions.

To use the ketorolac nasal spray:

  • Gently blow your nose before using the nasal spray.
  • The first time you use a new bottle, remove the clip and plastic cover and prime the unit by pumping 5 sprays into the air, away from your face, until a fine mist appears.
  • Tilt your head forward slightly and insert the tip of bottle into your nostril, pointing it away from the center of your nose. Breathe through your mouth while spraying gently into your nostril. Do not inhale or sniff while spraying. If your nose runs, gently sniff to keep the nasal spray from leaking out.
  • Use only the number of sprays prescribed by your doctor.
  • Put the plastic cap back on the bottle and store it in a dry place, out of direct sunlight.
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Avoid getting this medication in your eyes. If this does happen, rinse with water or saline solution. Call your doctor if you have eye irritation for longer than 1 hour.

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Do not use this medication for longer than 5 days unless your doctor has told you to.

Each bottle of this medicine contains 8 sprays for use within a 24-hour period. Throw the bottle away within 24 hours after your first use, even if there is still some medicine left in the bottle.

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Store the unopened nasal spray bottles in a refrigerator. Do not freeze.

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After opening a bottle, store it at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

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Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid while taking ketorolac nasal?

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Ask your doctor before using an antidepressant such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Rapiflux, Sarafem, Selfemra, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil, Pexeva), sertraline (Zoloft), trazodone (Desyrel, Oleptro), or vilazodone (Viibryd). Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

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Ask a doctor or pharmacist before using any other medicine for pain, arthritis, fiebre, or swelling. Many medicines available over the counter contain NSAIDs (such as aspirin, ibuprofen, ketoprofen, or naproxen). Taking certain products together can cause you to get too much of a this type of drug. Check the label to see if a medicine contains an NSAID.

What are the possible side effects of ketorolac nasal?

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Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

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Stop using ketorolac nasal and call your doctor at once if you have a serious side effect such as:

  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • sudden numbness or weakness, especially on one side of the body;
  • sudden severe headache, confusion, problems with vision, speech, or balance;
  • black, bloody, or tarry stools;
  • coughing up blood or vomit that looks like coffee grounds;
  • slow heart rate;
  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;
  • urinating less than usual or not at all;
  • swelling, rapid weight gain; or
  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

  • pain or irritation in your nose;
  • runny nose;
  • watery eyes;
  • throat irritation;
  • upset stomach, heartburn, constipation, diarrhea;
  • mild rash; or
  • headache, drowsiness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect ketorolac nasal?

Tell your doctor about all other medicines you use, especially:

  • dextran, heparin, or warfarin (Coumadin, Jantoven);
  • lithium (Eskalith, Lithobid);
  • methotrexate (Rheumatrex, Trexall);
  • thiothixene (Navane);
  • alprazolam (Xanax);
  • diuretics (water pills);
  • muscle relaxers;
  • steroids (prednisone and others);
  • aspirin or other salicylates, such as Nuprin Backache Caplet, Kaopectate, KneeRelief, Pamprin Cramp Formula, Pepto-Bismol, Tricosal, Trilisate, and others;
  • a heart or blood pressure medication such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro, Avalide), losartan (Cozaar, Hyzaar), valsartan (Diovan), telmisartan (Micardis), or olmesartan (Benicar);
  • an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), ramipril (Altace), and others;
  • other NSAIDs, such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others; or
  • seizure medications such as carbamazepine (Carbatrol, Equetro, Tegretol) or phenytoin (Dilantin).

There may be other drugs that can interact with ketorolac nasal. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about ketorolac.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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