Ketorolac Side Effects: What to Expect and When to Call Your Doctor

Ketorolac Side Effects: What You Need to Know

Ketorolac (sold under brand names like Toradol and Sprix) is a powerful NSAID used for short-term treatment of moderately severe acute pain. It works well — but like all medications, it comes with potential side effects that you should understand before starting treatment.

This guide covers the common side effects you might experience, the serious ones to watch for, and when you should call your doctor or go to the emergency room.

What Is Ketorolac?

Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that's significantly more potent than over-the-counter options like Ibuprofen or Naproxen. It's available as oral tablets, injections, a nasal spray (Sprix), and eye drops (Acular). For a complete overview, see our guide on what Ketorolac is and how it's used.

Because of its potency and risk profile, Ketorolac is limited to 5 days of use maximum across all forms combined. This strict time limit is there to protect you from serious complications.

Common Side Effects

Most people who take Ketorolac for a few days will experience mild side effects that resolve on their own. Based on FDA labeling, the most frequently reported side effects include:

• Nausea — The most common complaint. Taking oral Ketorolac with food or milk can help.
• Stomach pain or dyspepsia — A burning or uncomfortable feeling in the upper abdomen.
• Headache — May occur in the first day or two of use.
• Dizziness — Especially when standing up quickly.
• Drowsiness — Avoid driving or operating machinery if this affects you.
• Diarrhea — Usually mild and temporary.
• Edema (swelling) — Mild fluid retention, often in the hands, feet, or ankles.
• Injection site pain — Common with IM injection; the area may be sore for a day or two.

These side effects are generally manageable and tend to go away once you stop taking the medication.

Serious Side Effects

Ketorolac carries a boxed warning — the FDA's most serious safety alert — for several potentially life-threatening risks:

Gastrointestinal Bleeding and Ulcers

NSAIDs, including Ketorolac, can cause stomach ulcers, bleeding, and perforation (a hole in the stomach or intestinal wall). These events can happen without warning symptoms and can be fatal. Risk increases with:

• Longer duration of use (which is why the 5-day limit exists)
• Older age (65 and above)
• History of stomach ulcers or GI bleeding
• Concurrent use of blood thinners, corticosteroids, or other NSAIDs
• Alcohol use

Cardiovascular Events

Ketorolac may increase the risk of heart attack and stroke, especially with longer use or in patients with existing heart disease. Seek immediate medical attention if you experience chest pain, shortness of breath, sudden weakness on one side of the body, or slurred speech.

Kidney Problems

Ketorolac can cause acute kidney injury, particularly in patients who are dehydrated, elderly, or taking other medications that affect kidney function (such as ACE inhibitors or diuretics). Signs include decreased urination, swelling, and unusual fatigue.

Severe Allergic Reactions

Anaphylaxis — a life-threatening allergic reaction — can occur, especially in people with a history of asthma or allergic reactions to Aspirin or other NSAIDs. Symptoms include difficulty breathing, swelling of the face or throat, and hives.

Serious Skin Reactions

Rare but serious skin conditions like Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported. Seek emergency care if you develop a widespread rash, blistering, or peeling skin.

Liver Damage

Hepatotoxicity is possible, though uncommon. Watch for yellowing of the skin or eyes (jaundice), dark urine, or persistent nausea.

Bleeding Problems

Ketorolac impairs platelet function and can increase bleeding time. This is especially risky if you're taking blood thinners like Warfarin or antiplatelet drugs like Clopidogrel. Learn more about Ketorolac drug interactions.

Specific Populations at Higher Risk

Elderly Patients (65 and Older)

Older adults are at significantly higher risk for GI bleeding, kidney problems, and cardiovascular events. If you're 65 or older, your doctor should use a lower dose — typically a maximum of 60 mg/day for injection.

Pregnant Women

Ketorolac is contraindicated in the third trimester of pregnancy due to the risk of premature closure of the ductus arteriosus in the fetus. It should also not be used during labor and delivery.

Nursing Mothers

Ketorolac passes into breast milk. Use with caution if you're breastfeeding — talk to your doctor about whether the benefits outweigh the risks.

Children

Ketorolac is not recommended in children under 2 years old. For older children, it's sometimes used off-label for acute pain, but only under close medical supervision.

Patients With Kidney or Liver Problems

If you have impaired kidney function (creatinine clearance below 30 mL/min) or significant liver problems, Ketorolac may not be safe for you.

How to Manage Common Side Effects

If you experience mild side effects while taking Ketorolac, here are some practical tips:

• For nausea or stomach pain: Take oral tablets with food or milk. Avoid alcohol entirely.
• For dizziness or drowsiness: Stand up slowly, avoid driving, and don't operate heavy machinery.
• For swelling: Elevate your feet and limit salt intake.
• For injection site pain: Apply a cool compress to the area.
• Stay hydrated: Drink plenty of water to support kidney function.

Remember: you should never take Ketorolac for more than 5 days. If your pain isn't adequately controlled, talk to your doctor about alternative medications rather than extending your course.

When to Call Your Doctor or Go to the ER

Contact your doctor or seek emergency care immediately if you experience any of the following:

• Black, tarry, or bloody stools
• Vomiting blood or material that looks like coffee grounds
• Chest pain, shortness of breath, or sudden weakness
• Severe stomach pain
• Difficulty breathing, facial swelling, or hives
• Decreased urination or unusual swelling
• Yellowing of skin or eyes
• Widespread rash or blistering skin
• Unusual bleeding or bruising

Final Thoughts

Ketorolac is an effective short-term pain reliever, but its side effect profile is more serious than many people realize. The 5-day maximum usage limit exists for good reason — exceeding it dramatically increases your risk of GI bleeding, kidney damage, and cardiovascular problems.

Always take Ketorolac exactly as prescribed, report any unusual symptoms promptly, and never combine it with other NSAIDs or Aspirin. If you have questions about whether Ketorolac is safe for you, talk to your prescriber.

To learn more about how this medication works in your body, check out our article on Ketorolac's mechanism of action.