Dosage and Administration
Ketorolac tromethamine must not be used in children under 16 years of age. In adults, the loading dose is 30 to 60 mg IM/IV followed by a maintenance Dose --15 to 30 mg IM/IV every 6 hours or 10 mg po every 8-12 hours. Maximum Dose --150 mg on first day, then 120 mg per day, not to exceed 5 days.
Dosing Adjustments --A 30 mg loading dose and maintenance dose of 15 mg IM/IV q6h should be used for patients weighing 50 kg (110 lbs), patients over 65 years of age, or patients with decreased renal function (CrCl between 30 to 50 ml/min), and use should be discouraged in patients with CrCl less than 30 ml/min.
Ketorolac injection is indicated for the short-term management of pain, up to 5 days only. It is recommended to convert to oral NSAID therapy when the patient can tolerate oral medications. Concomitant use of anticoagulants (e.g., heparin, enoxaparin, warfarin) increases the risk of bleeding complications. Concomitant use of other NSAID therapy, including aspirin, may produce additive adverse effects.
The lowest effective dose should be given. A total daily dose of 90 mg for the non-elderly and 60 mg for the elderly should not be exceeded. (inserted article from the 5th reference below)
- The Rational Use of Parenteral Ketorolac; Nancy E. Sloan, Pharm.D.; P&T News: May 1994, Vol. 14, No. 11
- Incidence of hematoma associated with ketorolac after TRAM flap breast reconstruction; SHARMA Sanjay, CHANG David W., KOUTZ Cindy, EVANS Gregory R. D., ROBB Geoffrey L., LANGSTEIN Howard N., KROLL Stephen S.; Plastic and Reconstructive Surgery Journal, Vol 107, No 2, pp 352-355, 2001 (abstract here)
- Facial plastic meeting yields surgical pearls; Source: Dermatology Times, Originally published: June 1, 2002
- POSTOPERATIVE HEMATOMAS ASSOCIATED WITH TORADOL; Plastic & Reconstructive Surgery. 88(5):919, November 1991; Garcha, Iqbal S.; Bostwick, John M.D.
- PERSONAL EXPERIENCES WITH TORADOL; Plastic & Reconstructive Surgery. 89(6):1183, June 1992; Dowbak, Gregory M.D.
- The Effect of Ketorolac on Microvascular Thrombosis in an Experimental Rabbit Model; Plastic & Reconstructive Surgery. 98(1):140-145, July 1996.; Shufflebarger, John V. M.D.; Doyle, James Ph.D.; Roth, Tim M.S.; Maguire, Kevin M.D.; Rothkopf, Douglas M. M.D.