Ketorolac: Uses, Side Effects & Safety

What it is and what it's used for

Ketorolac is a powerful pain-relieving medicine belonging to the NSAID (non-steroidal anti-inflammatory drug) family, the same group as ibuprofen and diclofenac. It is used for the short-term management of moderate to moderately severe acute pain — for example, pain after surgery, dental work, or a musculoskeletal injury. Because it is stronger than many other painkillers, it is often used when milder painkillers are not enough.

In India, ketorolac is a prescription-only medicine (Schedule H). It is not an over-the-counter painkiller and should only be taken on a doctor's advice. It is meant for a few days at most, not for ongoing or chronic pain.

How it works (simple language)

Ketorolac works by blocking the body's production of substances called prostaglandins, which are chemicals that cause pain, swelling, and inflammation. By reducing these chemicals, it lowers pain and inflammation at the site of injury or surgery. It also has a mild fever-reducing effect, though it is not normally used just for fever.

Dosage forms available in India (general info only)

Ketorolac is commonly available in India as 10 mg tablets, and as an injection given in hospitals and clinics for post-operative pain. Well-known Indian brand names include Ketorol (Dr. Reddy's) and Ketal, though brands vary by pharmacy.

Never decide the dose yourself from this article. Always follow your doctor's prescription or the directions on the pack, and check with your pharmacist if you are unsure — especially for children, where the dose depends on the child's weight and age.

Side effects

Common: Stomach pain, nausea, vomiting, indigestion, headache, dizziness, drowsiness, and mild swelling of the hands or feet.

Serious — seek medical care: Stomach bleeding (black stools, vomiting blood or material that looks like coffee grounds), severe stomach pain, signs of kidney problems (very little urine, swelling of the legs), signs of a heart problem (chest pain, shortness of breath), allergic reactions (rash, swelling of the face or lips, difficulty breathing), and unusual bruising or bleeding. Seek emergency care immediately if any of these occur.

Precautions and warnings

• Short-term use only: Ketorolac is meant for a few days only. Longer use greatly increases the risk of stomach bleeding and kidney damage.
• Stomach and gut risk: Avoid it if you have active stomach ulcers, stomach bleeding, or a history of ulcers, and be cautious if you take blood thinners, steroids, or other NSAIDs at the same time.
• Kidney risk: It can harm the kidneys, especially in older adults, people who are dehydrated, and those with existing kidney or heart disease.
• Heart and blood pressure: Like other NSAIDs, it may raise blood pressure and increase the risk of heart attack or stroke, particularly with higher doses or longer use.
• Bleeding risk: It can increase bleeding, so tell your doctor before any surgery or dental procedure, and avoid it if you have a bleeding disorder.
• Asthma warning: People with asthma that is worsened by aspirin or other NSAIDs should avoid ketorolac.
• Alcohol: Avoid alcohol while taking it, as it increases the risk of stomach bleeding.
• Not for children under 16 as a routine painkiller: Use in children is limited and only under specialist supervision.

Interactions (general)

Ketorolac can interact with blood thinners (such as warfarin), other NSAIDs, aspirin, steroids, some blood pressure medicines (ACE inhibitors, diuretics), lithium, and methotrexate. Taking it together with other NSAIDs or steroids raises the risk of stomach bleeding. Always tell your doctor about ALL medicines you take, including herbal and ayurvedic products, and avoid alcohol during treatment.

Pregnancy and breastfeeding (general guidance)

Ketorolac should be avoided in pregnancy, especially in the third trimester, as it may harm the unborn baby and affect labour. It is generally not recommended while breastfeeding either. If you are pregnant, planning pregnancy, or breastfeeding, consult your doctor first before taking this medicine.

Storage

Store at room temperature, away from moisture and direct sunlight. Keep out of reach of children. Do not use after the expiry date printed on the pack, and dispose of expired tablets safely rather than flushing them down the drain.

When to see a doctor

See a doctor if: your pain does not improve within a couple of days, you develop stomach pain, black stools, vomiting blood, swelling, reduced urination, or a rash. Seek emergency care immediately for chest pain, shortness of breath, severe stomach pain, signs of an allergic reaction, or uncontrolled bleeding.

FAQs

1. Is ketorolac stronger than ibuprofen or paracetamol?

Yes, ketorolac is considered a stronger painkiller than ibuprofen or paracetamol and is usually reserved for moderate to severe acute pain, such as after surgery. Because of its stronger effects, it also carries a higher risk of stomach and kidney side effects, which is why it is prescription-only and short-term.

2. Can I take ketorolac for a long time for chronic pain?

No. Ketorolac is approved only for short-term use, typically a few days. Taking it for longer greatly increases the risk of stomach bleeding, kidney damage, and heart problems. For chronic pain, your doctor will choose a safer long-term option.

3. Can I take ketorolac on an empty stomach?

It is usually best taken with food or milk to reduce stomach irritation, but always follow the directions your doctor or pharmacist gives you. If you notice stomach pain or heartburn, tell your doctor rather than continuing on your own.

4. Is ketorolac safe for elderly people?

Older adults are more sensitive to ketorolac's side effects, especially stomach bleeding and kidney problems, so it is used with extra caution and usually at the lowest effective dose for the shortest time. Elderly patients should only take it under a doctor's close supervision.