Your Patient Needs Ketorolac — Here's How to Help Them Get It

You've prescribed Ketorolac for a patient with acute pain, and now they're calling back to tell you their pharmacy doesn't have it. This scenario has become increasingly common over the past several years, as Ketorolac injection has experienced recurring supply disruptions.

As a prescriber, you have several levers to pull to help your patients access this important medication — or transition them to an effective alternative quickly. This guide offers a practical, step-by-step approach.

Current Ketorolac Availability (Early 2026)

Understanding the supply landscape helps you set realistic expectations with patients:

• Ketorolac 10 mg oral tablets: Widely available at most retail pharmacies. Generic pricing is low — as little as $10 to $13 with a discount coupon.
• Ketorolac IV injection (15 mg/mL, 30 mg/mL): Generally available from multiple generic manufacturers, though occasional spot shortages occur at individual institutions.
• Ketorolac IM injection (60 mg/2 mL): This formulation has been the most frequently affected by shortages since 2020. Availability varies by distributor and region.
• Sprix nasal spray: Available by prescription but high cost without insurance ($1,700-$2,200). Limited retail stocking.
• Acular ophthalmic drops: Generic version widely available at $13 to $30.

For current shortage details, see our provider shortage briefing.

Why Patients Can't Find Ketorolac

When patients report difficulty finding Ketorolac, it's usually due to one or more of these factors:

Injectable Supply Constraints

The Ketorolac injection shortage has been driven by manufacturing disruptions at key producers (Hospira/Pfizer, Fresenius Kabi), limited numbers of generic manufacturers, and increased demand as providers shift toward non-opioid analgesic protocols.

Pharmacy Stocking Patterns

Retail pharmacies may not routinely stock injectable Ketorolac since it's most commonly used in clinical settings (ERs, surgical suites). Oral tablets are more commonly dispensed at retail but smaller pharmacies may carry limited quantities given the 5-day use restriction.

Formulation Confusion

Patients may not realize that Ketorolac comes in different forms. If they're looking for the injection at retail — or expecting Sprix at a pharmacy that doesn't carry it — they may incorrectly conclude the drug is unavailable when an alternative form exists.

Insurance and Cost Barriers

While generic Ketorolac tablets are inexpensive, Sprix nasal spray carries a high cash price and often requires prior authorization. Patients may report they "can't get it" when the real issue is insurance coverage rather than stock.

5 Steps Providers Can Take

Step 1: Confirm the Right Formulation

Before troubleshooting availability, make sure the prescribed formulation matches what makes clinical sense for the outpatient setting. For most patients being discharged or seen in office, oral Ketorolac 10 mg tablets are appropriate (following initial IV/IM therapy or as part of a clinical decision). Oral tablets are the easiest to find and most affordable.

Step 2: Direct Patients to Medfinder

Recommend that patients use Medfinder to search for real-time Ketorolac availability at pharmacies in their area. This tool eliminates the need for patients to call multiple pharmacies individually and can significantly reduce time to fill.

Consider adding a Medfinder recommendation to your after-visit summary or discharge instructions for patients receiving hard-to-find medications.

Step 3: Prescribe to a Pharmacy with Confirmed Stock

If a patient reports that their usual pharmacy is out of stock, offer to send the prescription to a different pharmacy. Many EHR systems allow you to search available pharmacies. Alternatively, have your staff call ahead to confirm stock before sending the e-prescription.

Independent pharmacies often have access to different distribution networks and may carry medications that chains don't.

Step 4: Consider Route or Formulation Alternatives

If injectable Ketorolac is unavailable for in-office administration:

• Diclofenac IV (Dyloject): Most similar injectable NSAID. 37.5 mg IV bolus.
• Ibuprofen IV (Caldolor): 400-800 mg IV over 30 minutes.
• Acetaminophen IV (Ofirmev): Not an NSAID but useful in multimodal protocols.

If the patient needs outpatient oral therapy and Ketorolac tablets are unavailable:

• Ibuprofen 600-800 mg PO every 6-8 hours
• Naproxen 500 mg PO every 12 hours
• Celecoxib 200 mg PO daily or BID (lower GI risk)
• Diclofenac 50 mg PO every 8 hours

See our full alternatives guide for detailed comparisons.

Step 5: Address Cost Barriers

If a patient can't afford their Ketorolac prescription:

• Generic oral tablets cost as little as $10 to $13 with discount coupons from GoodRx or SingleCare — often less than an insurance copay.
• For Sprix nasal spray, check if the manufacturer offers a copay card or patient assistance at sprix.com.
• Direct uninsured patients to NeedyMeds (needymeds.org) or RxAssist (rxassist.org) for patient assistance program information.
• For a comprehensive overview, share our savings guide for patients or review our provider savings guide.

Workflow Tips for Your Practice

Here are some practical ways to integrate shortage preparedness into your workflow:

• Maintain an alternative analgesic protocol. Have pre-approved NSAID alternatives documented so that when Ketorolac is unavailable, your team can pivot quickly without additional physician orders.
• Include Medfinder in discharge paperwork. Add a line to your after-visit summary: "If your pharmacy doesn't have this medication in stock, visit medfinder.com to search nearby pharmacies."
• Subscribe to ASHP shortage alerts. Stay informed about Ketorolac supply status so you can proactively adjust prescribing patterns before patients encounter problems.
• Coordinate with your pharmacy department. For institutional settings, work with your pharmacy team to set par levels, identify backup distributors, and establish automatic therapeutic substitution protocols.
• Consider patient assistance proactively. For uninsured or underinsured patients, provide cost-saving resources at the time of prescribing, not after the patient encounters a high price at the pharmacy.

Final Thoughts

Ketorolac availability challenges are an operational reality that providers can manage with the right strategies. By confirming formulation needs, leveraging real-time availability tools like Medfinder for Providers, maintaining flexible prescribing protocols, and proactively addressing cost barriers, you can minimize the impact of shortages on your patients' pain management.

For the patient-facing version of this guide, share our post on how to find Ketorolac in stock. For clinical details on the shortage, see our provider shortage briefing.