Common use: What Toradol (ketorolac) treats and when it helps
Toradol is an NSAID analgesic indicated for the short‑term management of moderately severe acute pain that typically requires analgesia at the opioid level, such as post‑operative pain, acute musculoskeletal injuries, renal colic, or acute dental pain. Unlike opioids, ketorolac does not cause physical dependence or respiratory depression, but it also does not treat chronic or neuropathic pain and is not appropriate for long‑term use. It can reduce the need for opioids in the immediate post‑operative period as part of a multimodal pain plan. Toradol is available in injectable (IV/IM), oral tablet, and intranasal forms; ophthalmic ketorolac exists but is a different product for eye inflammation.
A defining feature of Toradol is its strict five‑day total therapy limit for systemic use (injections plus tablets combined). This cap reflects the known risk of dose‑ and duration‑dependent adverse effects, especially gastrointestinal ulceration and bleeding and kidney injury. Patients with low cardiovascular and gastrointestinal risk who need brief, strong non‑opioid pain control may benefit most. Clinicians often initiate with IV or IM ketorolac in hospital or clinic settings, then transition to oral dosing to complete the short course if needed. Always discuss your medical history and bleeding, kidney, and heart risk factors before starting ketorolac.
Toradol dosage and direction
Dosing must be individualized, using the lowest effective dose for the shortest time, and never exceeding five total days of systemic therapy. Adults under 65 years with normal renal function: typical single IV dose is 30 mg (or 60 mg IM), or 15–30 mg IV/IM every 6 hours as needed, not to exceed 120 mg/day. For adults age 65 and older, those under 50 kg (110 lb), or those with renal impairment: use 15 mg IV/IM every 6 hours as needed, with a maximum of 60 mg/day. Oral ketorolac is generally used only as continuation after parenteral dosing: 10 mg initially, then 10 mg every 4–6 hours as needed, not exceeding 40 mg/day.
Intranasal ketorolac (Sprix) may be used short‑term for moderate to moderately severe pain when injections are impractical. Adults under 65 years typically use 31.5 mg (one spray in each nostril) every 6–8 hours, not exceeding 126 mg/day. For those 65 and older or with renal impairment, the dose is 15.75 mg every 6–8 hours, not exceeding 63 mg/day. Regardless of route, total duration must not exceed five days. Take oral tablets with food or milk to reduce stomach upset, and never combine with other NSAIDs (including ibuprofen, naproxen, or high‑dose aspirin) while on ketorolac.
Precautions before and during Toradol therapy
Toradol carries boxed warnings for serious gastrointestinal (GI) bleeding, ulcer, and perforation; cardiovascular thrombotic events (heart attack, stroke); and renal toxicity. Risk rises with dose and duration, in older adults, with prior peptic ulcer or GI bleed, concurrent anticoagulants, steroids, SSRIs/SNRIs, heavy alcohol use, smoking, or H. pylori infection. Avoid ketorolac after coronary artery bypass graft (CABG) surgery. It inhibits platelet function and may increase bleeding, so caution is critical around surgery and in patients with bleeding disorders. NSAIDs can cause fluid retention, worsen hypertension, and precipitate kidney injury, particularly in dehydrated patients or those on ACE inhibitors/ARBs and diuretics. Report black/tarry stools, vomiting blood, chest pain, shortness of breath, sudden weakness, severe abdominal pain, decreased urine, swelling, or rash immediately.
Contraindications: When Toradol should not be used
Do not use ketorolac in patients with active peptic ulcer disease, recent GI bleeding or perforation, history of NSAID‑related GI bleeding/ulcer, advanced renal impairment or risk of renal failure due to volume depletion, hemorrhagic diathesis, suspected or confirmed cerebrovascular bleeding, or high bleeding risk. Ketorolac is contraindicated during labor and delivery (risk of fetal circulation compromise), and should be avoided from 20 weeks’ gestation onward due to fetal renal dysfunction and oligohydramnios; it is contraindicated in the third trimester. Do not administer intrathecally or epidurally. Concomitant use with other NSAIDs or aspirin at analgesic doses, probenecid, or pentoxifylline is contraindicated. Use in pediatrics is limited; oral ketorolac is not approved for children.
Possible side effects of Toradol
Common adverse effects include nausea, dyspepsia, abdominal pain, diarrhea, headache, dizziness, drowsiness, edema, sweating, and injection‑site pain. Less common but serious reactions include GI ulceration, bleeding, or perforation; renal injury (reduced urine, elevated creatinine, swelling, hyperkalemia); hepatotoxicity (elevated liver enzymes, jaundice); severe skin reactions (Stevens‑Johnson syndrome, toxic epidermal necrolysis); anaphylaxis or bronchospasm (especially with aspirin‑exacerbated respiratory disease); hypertension, heart failure exacerbation, and thrombotic cardiovascular events; and postoperative bleeding. Stop the medication and seek urgent care for black stools, vomiting blood, severe or persistent stomach pain, chest pain, sudden weakness or slurred speech, trouble breathing, facial or throat swelling, hives, peeling rash, markedly decreased urination, or yellowing of the skin or eyes.
Drug interactions: What to avoid with Toradol
Avoid using Toradol with other NSAIDs (ibuprofen, naproxen, diclofenac) or high‑dose aspirin due to additive GI and renal toxicity. Combining with anticoagulants (warfarin, heparin), antiplatelets (clopidogrel), SSRIs/SNRIs, or systemic corticosteroids heightens bleeding risk. ACE inhibitors/ARBs and diuretics can interact to impair renal perfusion (“triple whammy”), increasing acute kidney injury risk—ensure hydration and monitoring. Probenecid and pentoxifylline are contraindicated. Ketorolac may raise lithium levels and increase methotrexate toxicity; monitor or avoid. Calcineurin inhibitors (cyclosporine, tacrolimus) carry additive nephrotoxicity. Alcohol raises GI bleeding risk. Always provide a complete medication and supplement list—especially blood thinners, mood medications, migraine drugs, and over‑the‑counter pain relievers—so your clinician can prevent harmful combinations.
Missed dose
Toradol is typically taken on an as‑needed schedule within prescribed intervals. If you are on a scheduled regimen and miss a dose, take it when you remember unless it is close to the next dose—then skip the missed dose and resume your usual timing. Do not double up. Respect minimum intervals (every 4–6 hours for oral, every 6 hours for IV/IM or intranasal) and never exceed the daily maximums or the five‑day total duration. If pain persists or worsens, contact your clinician rather than self‑increasing the dose.
Overdose
Ketorolac overdose may present with severe stomach pain, nausea, vomiting, drowsiness, dizziness, black or bloody stools, vomiting blood, kidney problems (reduced urine, swelling), high potassium, low blood pressure, breathing difficulties, or coma. Serious GI bleeding and acute kidney failure are medical emergencies. If an overdose is suspected, call your local emergency number or Poison Control (in the U.S., 1‑800‑222‑1222) immediately. Do not induce vomiting unless instructed by medical professionals. Bring the medication container and any co‑ingested substances to the emergency department to assist treatment.
Storage
Store Toradol tablets and injectable vials at controlled room temperature (68–77°F or 20–25°C), protected from light and moisture, and keep in the original container with the label intact. Do not freeze injectable solutions. Intranasal products should be stored and used per the package insert, with attention to discard timelines after opening. Keep all medications out of reach of children and pets. Properly dispose of expired or unused NSAIDs; for injectables, use a sharps container for needles and follow local guidelines or pharmacy take‑back programs for safe disposal.
U.S. Sale and Prescription Policy
In the United States, Toradol (ketorolac) is a prescription‑only medicine. Buying or using ketorolac without a valid prescription is not legal and can be dangerous. We cannot assist with obtaining Toradol without a prescription. The safe, lawful path is to be evaluated by a licensed clinician who can determine whether ketorolac is appropriate and, if so, prescribe it within the FDA‑mandated limits. HealthSouth Hospital of Altamonte Springs supports a legal and structured process by connecting patients with compliant telehealth consultations and coordinating dispensing after a clinician issues a valid prescription. This approach preserves safety, verifies medical necessity, and ensures you receive authentic medication and proper counseling.
