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Ketorolac is the generic name for the prescription drug Toradol®, a medication used for analgesia, or the short-term reduction of pain. Other uses of ketorolac include the relief of eye pain and the burning or itching associated with sinus infections and seasonal allergies. As a member of a class of medications known as non-steroidal anti-inflammatory drugs, there are a number of risks of ketorolac that may affect certain patient populations more than others, requiring a dosage adjustment or alternative medication. Other factors that can make an adjustment to an initial ketorolac dose necessary are age, decreased kidney function, and the drug delivery method to be used.
The standard adult dose is 30 mg given every six hours, and the total ketorolac dose should not exceed 120 mg within a 24 hour period. When administering the medication to an adult patient who is younger than 65, a single intramuscular ketorolac dose of 60 mg or a single intravenous dose of 30 mg should be used. In some cases, adult patients may need only half this dosage. Patients who are 65 years of age or older, who weigh less than 110 pounds (50 kg), or who have diminished kidney function should be given no more than 15 mg each six hour period and are not to exceed a dose of 60 mg in a day.
When administered orally, a dose of 10 mg given four times daily is recommended. This ketorolac dose should not be exceeded even for breakthrough pain relief, nor should maintenance doses be used. It may be better to use opioid-based painkillers alongside ketorolac instead. No dosage adjustments are needed for geriatric or low body weight patients. Oral administration of ketorolac should only be used to continue treatment after an initial intramuscular or intravenous pain management regimen.
In patients between the ages of two and 16, ketorolac may be given either intravenously or intramuscularly. However, ketorolac has not been approved for oral use in pediatric populations. The standard single intramuscular ketorolac dose in pediatrics is 30 mg, while that for intravenous administration is 15 mg.
The risks of ketorolac as a pain medication are considerable and increase over time, making it unwise to administer ketorolac to a patient for longer than a five-day period. Due to the high incidence of fatal side effects, many countries have withdrawn the drug's approval. In the countries that still allow ketorolac to be used in medicine, many strictly regulate the period of time that it may be given.
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