FormWeb • ketorolac

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ketorolac

ketorolac

Brand names: Toradol

Form	Strength
SOLUTION, INJECTABLE	15 mg/mL; 30 mg/mL
TABLET, ORAL	10 mg

Display Other Nonsteroidal Anti-inflammatory Agents Class: 28080492

Medication comments:

Note: ketorolac for IV or PO use is limited to 5 days per policy.

Per policy, these drugs are subject to renal dosing adjustments by pharmacy.
Generic + Route (Brand) • Indications	Usual Adult Dose Comments	Renal Dosage Adjustments
ketorolac IV/IM (Toradol^©)	15-30 mg q6h, 15 mg dose for pts ≥ 65 yrs. max 120 mg per day (max 60 mg per day with renal impairment) *Single doses of ketorolac > 30 mg are discouraged due to increased risk for nephrotoxicity.*	eGFR > 50 mL/min/1.73m²: no adjustment necessary eGFR < 50 mL/min/1.73m²: 7.5-15 mg q6h eGFR < 30 mL/min/1.73m²: avoid using all NSAIDS eGFR < 10 mL/min/1.73m²: *Contraindicated*
ketorolac PO (Toradol^©)	10 mg q4-6h max 40 mg per day	eGFR > 50 mL/min/1.73m²: no adjustment necessary eGFR < 50 mL/min/1.73m²: 10 mg q4-6h (max 40 mg/day) eGFR < 30 mL/min/1.73m²: avoid using all NSAIDS eGFR < 10 mL/min/1.73m²: *Contraindicated*

Per policy, orders for these non-formulary agents will be changed to formulary equivalents.
Non-Formulary Agent	Formulary Equivalent
ketorolac (Toradol) if ≥ 65 years old	IM: 30 mg x1 or 15 mg q6h (max of 60 mg/day) IV: 15 mg q6h (max of 60 mg/day) PO: 10 mg q4-6h prn (max of 40 mg/day)

Anticoagulant / Antiplatelet Stoppage For Procedures
generic (Brand)	Dept.	Procedure Type (hover over entry for examples)	Stop Medication Prior To Procedure Restart after:
ketorolac (Toradol)	Anesthesia	High-risk	24 hours Restart after 24 hours
		Intermediate-risk	No hold Restart after 24 hours
		Low-risk	No hold Restart after 24 hours
		Patients with high risk of bleeding (eg, old age, history of bleeding tendency, concurrent uses of other anticoagulants/antiplatelets, liver cirrhosis or advanced liver disease, and advanced renal disease) undergoing low- or intermediate-risk procedures should be treated as intermediate or high risk, respectively.

	Radiology	Invasive Procedures	24 hours
	Radiology	Paracentesis/Thoracentesis	No hold
	Surgery	High-risk	7 days Restart after 24 hours
	Surgery	Low-risk	No Hold Restart after 24 hours

Last updated: May. 1, 2024

Renal Adjustment Policy ketorolac subject to adjustments by pharmacy.
Black Box Warnings Duration of therapy; max dose; GI, cardiovascular, bleeding, renal risk
Look-Alike/Sound-Alike ketorolac confused with Ketalar, methadone

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556

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The content of this policy and procedure document serves as guidance to the delivery of quality patient care.
Care providers are expected to exercise critical thinking and situational awareness skills,
and in specific situations to take such action as is necessary for the delivery of quality patient care.