Alert

ketorolac (nasal)

Pronunciation: KEE toe ROLE ak (NAY sul)

Brand: Sprix

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

You should not use this medicine if you have severe kidney disease, a bleeding or blood clotting disorder, bleeding in your brain, a stomach ulcer or history of stomach bleeding, or if you have ever had a severe allergic reaction after taking aspirin or an NSAID. Do not use this medicine for longer than 5 days.

Ketorolac can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ketorolac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults.

Pentoxifylline or probenecid can interact with ketorolac and should not be used at the same time.

What is ketorolac nasal?

Ketorolac is a nonsteroidal anti inflammatory drug (NSAID).

Ketorolac nasal (for the nose) 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 using ketorolac nasal?

Ketorolac can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ketorolac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults.

You should not use this medicine if you are allergic to ketorolac, or if you have:

  • severe kidney disease;
  • a bleeding or blood clotting disorder;
  • a closed head injury or bleeding in your brain;
  • a stomach ulcer, perforation, or a history of stomach or intestinal bleeding; or
  • if you are breast-feeding a baby; or
  • if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

Pentoxifylline or probenecid can interact with ketorolac and should not be used at the same time.

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).

Tell your doctor if you have ever had:

  • heart disease, high blood pressure;
  • a heart attack, stroke, or blood clot;
  • stomach ulcers or bleeding;
  • ulcerative colitis or Crohn's disease;
  • asthma;
  • liver or kidney disease;
  • fluid retention; or
  • if you smoke.

Using ketorolac during the last 3 months of pregnancy may harm the unborn baby. Ketorolac may also increase the risk of uterine bleeding and is not for use during labor and delivery. Tell your doctor if you are pregnant.

Ketorolac may affect ovulation, which could temporarily affect fertility (your ability to have children).

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

Ketorolac nasal is not approved for use by anyone younger than 2 years old.

How should I use ketorolac nasal?

Follow all directions on your prescription label and read all medication guides. Use the lowest dose that is effective in treating your condition.

Ketorolac nasal is usually given every 6 to 8 hours. Use only the number of sprays prescribed by your doctor.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Do not use ketorolac 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 24 hours after your first use, even if there is still medicine left inside.

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

After opening a bottle, store it at room temperature in a dry place, out of direct sunlight.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

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

What should I avoid while using ketorolac nasal?

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.

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid taking aspirin or other NSAIDs while you are using ketorolac nasal.

Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to ketorolac (such as aspirin, ibuprofen, ketoprofen, or naproxen).

What are the possible side effects of ketorolac nasal?

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, leg swelling, feeling short of breath.

Stop using ketorolac and call your doctor at once if you have:

  • any skin rash, no matter how mild;
  • high blood pressure --severe headache, blurred vision, pounding in your neck or ears;
  • heart problems --swelling, rapid weight gain, feeling short of breath;
  • kidney problems --little or no urination, swelling in your feet or ankles, feeling tired or short of breath;
  • liver problems --nausea, upper stomach pain, itching, tiredness, flu-like symptoms, dark urine, jaundice (yellowing of the skin or eyes);
  • low red blood cells (anemia) --pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or
  • signs of stomach bleeding --bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.

Common side effects may include:

  • heartburn, stomach pain, gas, nausea, vomiting;
  • diarrhea, constipation;
  • slow heartbeats;
  • decreased urination;
  • abnormal liver function tests;
  • increased blood pressure;
  • pain or irritation in your nose;
  • runny nose;
  • watery eyes;
  • throat irritation; or
  • rash.

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?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Ask your doctor before using ketorolac if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all your other medicines, especially:

  • lithium;
  • methotrexate;
  • a blood thinner --warfarin, Coumadin, Jantoven;
  • heart or blood pressure medication, including a diuretic or "water pill"; or
  • seizure medicine --carbamazepine, phenytoin.

This list is not complete. Other drugs may affect ketorolac, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about ketorolac nasal.

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.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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