Ketorolac is used to help relieve moderate to moderately severe pain.
Use Ketorolac nasal spray exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor.
If you are using the nasal spray for the first time, you need to activate the pump first. To activate it, hold the bottle at arm's length away from your body. Place your index finger and middle finger on the top of the flange, while supporting the bottom with your thumb. Press down evenly and release the pump 5 times. There is no need to activate the pump again if more doses will be used from the bottle.
To use the nasal spray, follow these steps:
- Blow your nose gently to clean the nostrils before using the spray.
- Sit up straight or stand, then tilt your head slightly forward.
- Insert the tip of the nasal spray bottle into your right nostril. Aim the bottle away from the centre of your nose.
- Hold your breath and spray 1 time into your right nostril, pressing down evenly on both sides of the finger flange. You may pinch your nose to help keep the medicine in your nose if it starts to drip.
- Breathe gently through your mouth after administration.
- Repeat steps 3-5 on your left nostril if your doctor advised you to do so.
- Wipe and cap the nasal spray after each use.
Make sure you know how to use your nasal spray. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
Do not share your nasal spray with others as it could spread infection.
Do not use Ketorolac nasal spray for more than 5 days. This medicine is indicated only as a short-term pain relief therapy. Your doctor will advise you on the dose and duration of your treatment.
Use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
Do not use this medicine if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes, asthma) to Ketorolac or other similar medicines such as aspirin and other non-steroidal anti-inflammatory drugs [NSAIDs] (medicines for pain and inflammation).
Alert your doctor if you have the following conditions:
- active or history of stomach ulcer or bleeding
- recent perforation (a hole that starts along the organ wall of the body) or bleeding in the stomach or bowel
- bleeding disorders or at high risk of bleeding
- advanced kidney disease or at risk for kidney failure due to low fluid volume in the body
as Ketorolac may not be suitable for you.
Do not use this medicine if you are in your 3rd trimester of pregnancy.
Ketorolac should not be used to treat pain in the setting of coronary artery bypass graft surgery (a procedure to improve and restore the blood flow in the heart), during labour and delivery, or for the prevention of pain before any major surgery.
Do not use this medicine with other NSAIDs, or medicines used to treat gout or circulation problems. Please see the section "Can I use this with other medicines?" below for more information.
Inform your doctor if you have the following conditions:
- history of bowel inflammation e.g. ulcerative colitis (inflammation of the large intestines), Crohn's disease (long-term inflammatory disease of the digestive tract)
- recent heart attack
- high blood pressure
- diabetes
- other forms of asthma
- low body weight (<50 kg)
- mild or history of kidney disease
- liver disease
Let your doctor know if you are in your 1st or 2nd trimester of pregnancy, or if you are breastfeeding.
Notify your doctor if you consume alcohol or if you are a smoker.
Be sure to check with your doctor or pharmacist before giving Ketorolac to the elderly or debilitated patient (physically or mentally weak, usually due to illness or old age). Elderly people and debilitated patients may be more sensitive to the side effects.
If you are going for an operation, including minor surgery and dental work, inform your doctor or dentist that you are using this medicine.
Routine tests (e.g. complete blood count, liver and renal function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
Ketorolac may cause any of the following side effects: nose discomfort, pain, or irritation, runny nose, throat irritation, and watery eyes.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swelling of the face, eyes, or mouth
- rashes with peeling of the skin or blistering of the lips, mouth, or eyes accompanied by fever
- pass out bloody or black as tar stools and vomiting blood or ground coffee-like material
- unable to pass urine or change in how much urine is passed, blood in the urine
- yellowing of the skin or eyes, severe stomach pain, dark coloured urine, tiredness
- chest pain
- slurred speech, weakness in one side or part of the body, change in balance
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not use Ketorolac with the following medicines:
- other NSAIDs (medicines for pain and inflammation) e.g. aspirin, ibuprofen
- probenecid (medicine for gout [high uric acid level in the blood])
- pentoxifylline (medicine used to improve blood flow)
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- water pills or medicines for water retention e.g. furosemide
- medicines for high blood pressure e.g. captopril, losartan, propranolol
- anti-inflammatory medicines e.g. prednisolone
- medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine
- medicines for mood disorders e.g. lithium, tiotixene
- medicines for depression e.g. fluoxetine
- blood-thinning medicines e.g. warfarin
- digoxin (medicine for heart disease)
- methotrexate (medicine for cancer or certain immune disorders)
- ciclosporin (medicine used in organ transplant or certain immune disorders)
- alprazolam (medicine for anxiety)
This list does not include all medicines that may interact with Ketorolac.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Store unopened nasal spray bottles in the refrigerator, between 2-8°C. Do not freeze, otherwise, this medicine will become ineffective and should not be used.
Once it is opened, store the bottle in an upright position in a cool, dry place away from the reach of children.
Protect from light or direct sunlight.
Medicines must not be used past the expiry date.
Throw away each bottle within 24 hours of priming, even if it still contains any unused medicine.
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