Limitations of Ketorolac

Hey everyone,

I’m in the great state of Maine right now!  Ahhh, the beauty of the internet!

Here’s a question/answer situation from a GPA.com member about ketorolac, a Non-Steroidal Anti-Inflammatory Drug (aka a pain reliever):

Hi Cate,

Here is a question that I have not been able to find the answer to:
Why is Toradol (ketorolac) limited to 5 days usage when given
by mouth?  Is it simply the adverse GI effects?

The restriction of keeping the max duration of treament with ketorolac at 5 days does pretty much boil down to the serious GI adverse effects associated with the medication.  When I say serious GI adverse effects, I mean GI issues that have resulted in death!

Prior to label revisions on the product, the incidence of ketorolac-induced GI adverse effects was much higher than most of the other NSAIDs (evidence from studies).  Chances of experiencing GI adverse effects with ketorolac increase with higher doses and longer duration of treatment.

Studies have shown that ketorolac works no better than the other members of its class.  Now, we do know that some NSAIDs work better than others for certain individuals.  Not everyone is the same!  Maybe ketorolac is the best for one person, but that’s not the case for most people.

The good news is there are so many NSAIDs out there, there’s a good chance an individual would not have to rely on ketorolac as their only option for pain relief.    Knowing there’s no significant difference in efficacy between ketorolac and the other NSAIDs, prescribers should keep the use of ketorolac to a max of 5 days…why bother risking it?!

NSAID-induced upper GI bleeding depends on the particular drug used, its dose, duration of treatment, patient risk factors (i.e. history of GI trouble, advanced age, etc.), and other medications on the patient’s drug list.  Based on clinical experience and data from studies, ketorolac would not be the drug of choice when deciding which NSAID to use for pain management.  This, as I mentioned above, is because of its high potential for causing GI adverse effects.

When should ketorolac be used?  It should be left for those patients with moderate to severe acute pain who failed to get relief with other NSAIDs, who cannot stand the effects of opioids, or who need a lower dose of an opioid (using ketorolac in addition to the opioid allows for a lower dose of the opioid).

Hope this info helps!

Need some more information on this topic?  Did my message not make sense (sometimes I feel like my words can be confusing!)?  If so, leave a message below or e-mail me at Cate@getpharmacyadvice.com.

Make sure you get your hands on our free video course on how to save money on your prescription medications…the holiday season is fast-aprroaching so best to have as much moolah in your bank accounts as possible!

Happy weekend!

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