What Is Ketorolac?

Ketorolac (brand names Toradol, Sprix, Acular) is a powerful nonsteroidal anti-inflammatory drug (NSAID) used for the short-term management of moderately severe acute pain that requires opioid-level analgesia. It is available as oral tablets, injectable solution, nasal spray, and ophthalmic drops.

Ketorolac is unique among NSAIDs because of its strong analgesic (pain-relieving) potency — it is often used in emergency departments and post-surgical settings as a non-opioid alternative for acute pain. The ophthalmic formulations (Acular, Acular LS) are used to reduce eye inflammation after cataract surgery and treat seasonal allergic conjunctivitis.

Important: Ketorolac is intended for short-term use only — the total duration across all formulations must not exceed 5 days due to the risk of serious side effects.

How does Ketorolac work?

Ketorolac works by inhibiting both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. These enzymes are responsible for converting arachidonic acid into prostaglandins — chemicals that promote pain, inflammation, and fever. By blocking prostaglandin production, Ketorolac effectively reduces pain and inflammation.

Ketorolac is a non-selective COX inhibitor with significantly higher analgesic potency than most other NSAIDs like Ibuprofen or Naproxen, making it especially effective for acute moderate-to-severe pain in short-term settings.

What doses are available for Ketorolac?

• Oral tablets: 10 mg
• Intramuscular injection: 60 mg/2 mL
• Intravenous injection: 15 mg/mL, 30 mg/mL
• Nasal spray (Sprix): 15.75 mg per spray
• Ophthalmic solution (Acular): 0.5%
• Ophthalmic solution (Acular LS): 0.4%

How hard is it to find Ketorolac in stock?

Ketorolac oral tablets are generally available at most pharmacies without difficulty. However, Ketorolac injection has experienced intermittent shortages since 2020 due to manufacturer production issues and demand surges. As of early 2026, supply has improved with multiple manufacturers (Hospira/Pfizer, Fresenius Kabi, Hikma, Athenex) back in production, but some injectable formulations may still see periodic limited availability. The brand-name nasal spray Sprix can be harder to find and significantly more expensive. If you're having trouble finding Ketorolac, Medfinder can help you locate pharmacies with it in stock near you.

Who Can Prescribe Ketorolac?

Ketorolac is most commonly prescribed by:

• Emergency Medicine physicians — for acute pain in the ER
• Surgeons (general, orthopedic, oral/maxillofacial) — for post-operative pain
• Anesthesiologists — as part of multimodal pain management
• Pain Management specialists
• Primary Care and Family Medicine physicians — for short-term acute pain
• Ophthalmologists — for ophthalmic formulations after eye surgery
• Sports Medicine physicians

Since Ketorolac is not a controlled substance, any licensed prescriber (MD, DO, NP, PA) can prescribe it. It is commonly administered in hospitals and clinics via injection, with oral tablets given as follow-up only.

Is Ketorolac a controlled substance?

No, Ketorolac is not a controlled substance. It is not scheduled by the DEA. Despite its potent analgesic effects comparable to some opioids, Ketorolac does not carry a risk of addiction or dependence. This makes it an important non-opioid option for managing acute pain, especially in patients with opioid use disorder or those at risk for opioid dependence.

Common Side Effects of Ketorolac

Like all NSAIDs, Ketorolac can cause side effects. Common side effects include:

• Nausea
• Stomach pain or dyspepsia
• Headache
• Dizziness
• Drowsiness
• Diarrhea
• Edema or swelling
• Injection site pain (for injectable forms)

Serious side effects (seek medical attention immediately):

• GI bleeding, ulceration, or perforation
• Heart attack or stroke symptoms
• Signs of kidney problems (decreased urination, swelling)
• Severe allergic reactions (difficulty breathing, hives, swelling of face/throat)
• Serious skin reactions (blistering, peeling rash)

Important: Ketorolac carries a boxed warning about cardiovascular and GI risks. Total use must not exceed 5 days across all formulations.

Alternative Medications to Ketorolac

If you cannot find or take Ketorolac, your doctor may consider these alternatives:

• Ibuprofen — Available OTC and by prescription; less potent but safer for longer-term use; available in oral and IV (Caldolor) forms
• Diclofenac — Prescription NSAID available in oral, topical, and injectable (Dyloject) forms with similar anti-inflammatory potency
• Naproxen — OTC/prescription NSAID with a longer half-life allowing twice-daily dosing; commonly used for acute and chronic pain
• Celecoxib (Celebrex) — A COX-2 selective NSAID with lower GI bleeding risk; prescription only; a good alternative for patients at high GI risk

Always consult your doctor before switching medications. You can use Medfinder to check availability of these alternatives near you.

Drug Interactions with Ketorolac

Ketorolac has several important drug interactions. Tell your doctor about all medications you take, especially:

• Other NSAIDs or Aspirin — Contraindicated; increases risk of GI bleeding
• Anticoagulants (Warfarin, Heparin) — Significantly increased bleeding risk
• Lithium — Ketorolac can increase lithium blood levels to toxic ranges
• Methotrexate — Increased methotrexate toxicity
• ACE Inhibitors and ARBs — Reduced blood pressure control and increased kidney risk
• Diuretics — Reduced diuretic effect and increased kidney risk
• Probenecid — Contraindicated; increases Ketorolac levels
• Pentoxifylline — Contraindicated; increased bleeding risk
• SSRIs and SNRIs — Increased bleeding risk
• Cyclosporine — Increased risk of kidney damage
• Corticosteroids — Increased GI bleeding risk

Avoid alcohol while taking Ketorolac, as it increases the risk of stomach bleeding and irritation.

Final Thoughts on Ketorolac

Ketorolac remains one of the most effective non-opioid options for short-term management of moderate-to-severe acute pain. While generic oral tablets are widely available and affordable ($10–$25 without insurance), the injectable form has experienced intermittent supply issues. If you're struggling to find Ketorolac in stock at your local pharmacy, Medfinder can help you locate nearby pharmacies with availability.

Remember that Ketorolac is intended for short-term use only (5 days maximum) and carries important safety warnings. Always follow your doctor's instructions and report any concerning side effects promptly.