Page 138 - 2026 SMOG

KETOROLAC (TORADOL)
Class/Mechanism of Action
• Nonsteroidal Anti-Inflammatory Drug (NSAID)
Inhibits cyclooxygenase (COX-1 & 2) enzymes, which decreases the production of
prostaglandin precursors. Provides antipyretic, analgesic, and anti-inflammatory action.
Indications
• Labeled Indications
˚ Short-term management of moderate to severe acute pain as an opioid alternative
Contraindications
• Hypersensitivity to Ketorolac, Aspirin, other NSAIDs, or any component of the formulation
• High risk of bleeding, recent history of GI bleeding or perforation, known history of peptic
ulcer disease
• Not for use as pain management for battlefield trauma patients!
• Suspected cerebrovascular bleeding
• Renal disease or patients at risk of renal failure secondary to volume depletion
• Concurrent use with other NSAIDs: Significant drug interactions exist. Requires dose/
frequency adjustment or avoidance
Adverse Reactions/Precautions
• Inhibits platelet function
• Associated with an increased risk of adverse cardiovascular thrombotic events, including MI
and stroke
• May increase risk of GI irritation, inflammation, ulceration, bleeding, and perforation
• Hyperkalemia: increased risk in patients >65 years of age
• May cause severe bronchospasm in patients with asthma
• May cause new-onset hypertension or worsening of existing hypertension
• Pregnancy: Use of NSAIDs should be avoided by 20 weeks’ gestation.
• Lactation: Use caution
Dose/Administration
PEDIATRIC
ADULT
(Always reference Broselow Tape)
Pain Management Pain Management
(Acute; Moderately Severe) (Acute; Moderately Severe)
• IV • Children <2
˚ Adults ≥50kg: 15–30mg q6hr ˚ IV
(max DAILY dose: 120mg)
0.25mg/kg q6–8hr (max dose:
■
˚ Adults ≥65 years and/or adults ≤50kg: • Children 2–16 years old:
15mg/dose)
15mg q6hr (max DAILY dose: 60mg)
• IM ˚ IM/IV
˚ Adults ≥50kg: 15–30mg q6hr (max ■ 0.5mg/kg q6–8hr (max dose:
DAILY dose: 120mg)
30mg/dose)
˚ Adults ≥65 years and/or adults ≤50kg: • Adolescents >17
Refer to the adult dose
15–30mg q6hr (max DAILY dose: 60mg)
˚
Note: Not recommended as a first-line choice
in pediatric patients
130 • MEDICATIONS