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Ketorolac, also known as Toradol, is a medication that requires careful use to minimize potential risks. Below are important safety and warning details that should be considered by patients and healthcare professionals:

• Heart Attack and Stroke Risk: This medication may increase the likelihood of blood clots, potentially leading to heart attacks or strokes. The risk is heightened if you have a history of heart problems, are taking high doses, or use it for more than five days. Avoid using ketorolac if you have had or will undergo heart surgery. Seek immediate medical attention if you experience chest pain, shortness of breath, or weakness on one side of your body.

• Serious Bleeding: Ketorolac can cause severe bleeding, including brain bleeds and stomach ulcers. These can occur suddenly and may be life-threatening if untreated. Higher risk groups include older adults, those with a history of stomach issues, liver problems, or those taking other medications that increase bleeding risk. Limit use to the lowest effective dose for the shortest time. Get medical help if you experience faintness, severe headaches, vomiting blood, or unusual stomach pain.

• Kidney Damage: This drug can adversely affect kidney function, especially if you are older, have diabetes, or are on medications that impact kidneys. Your healthcare provider may monitor your kidney health through tests. Seek medical advice if you notice changes in urination, fatigue, or muscle cramps.

• Avoidance with Other NSAIDs: Using ketorolac with other NSAIDs raises the risk of side effects like bleeding and kidney issues. Check all medications, including over-the-counter ones, for hidden NSAIDs.

• Special Populations: Individuals over 65, with low body weight, or existing kidney problems face a higher risk of serious side effects. Discuss safer pain management alternatives with your healthcare provider.

• High Blood Pressure and Heart Failure: Ketorolac can cause fluid retention, potentially raising blood pressure or causing heart failure. Discuss your cardiovascular history with your healthcare provider before starting this medication. Some forms contain sodium, which requires caution if you're on a low-salt diet.

• Liver Damage: Although rare, ketorolac may cause liver damage or failure. Contact healthcare services immediately if you observe symptoms like jaundice, severe stomach pain, or dark urine.

• Severe Allergic Reactions: Anaphylaxis and other severe reactions are possible, especially if you have aspirin or NSAID allergies. Discontinue use and seek emergency medical care if symptoms like facial swelling or difficulty breathing occur.

Contraindications: Do not use ketorolac if you have active peptic ulcers, a history of asthma triggered by NSAIDs, or pre-existing severe kidney issues. It should not be used for pain prevention before surgery or during labor. Avoid if you are taking other NSAIDs, probenecid, or pentoxifylline.

Always consult with your healthcare provider to assess the risks and benefits of ketorolac in the context of your health condition and medication history.

Common side effects:

• Pain at the injection site
• Dizziness
• Drowsiness
• Headache
• Upset stomach
• Nausea
• Indigestion
• Constipation
• Diarrhea
• Itching

Less common but important to monitor:

• Increase in blood pressure
• Fainting
• Fast or pounding heartbeat
• Hearing changes
• Mental or mood alterations (e.g., confusion or depression)
• Vision changes
• Easy bruising or bleeding
• Symptoms of heart failure (e.g., swelling of the ankles or feet, unusual tiredness, sudden weight gain)

Serious side effects:

• Liver damage (e.g., persistent nausea or vomiting, dark urine, stomach or abdominal pain, yellowing of the skin or eyes)
• Severe allergic reactions (e.g., fever, swollen lymph nodes, rash, severe dizziness, trouble breathing)
• Serious skin reactions (e.g., reddening, blisters, rash)
• Stomach bleeding (e.g., feeling faint, vomiting blood, bloody or dark stools)
• Heart attack or stroke symptoms (e.g., chest pain or tightness, pain radiating to the shoulder or jaw, slurred speech, weakness in one part of the body)
• Kidney problems (e.g., tiredness, dry skin, reduced appetite, changes in urination patterns)

Interactions with high risk of serious adverse effects and should be avoided:

• Aspirin
• Ibuprofen
• Naproxen
• Warfarin
• Dabigatran
• Enoxaparin
• Clopidogrel
• Methotrexate

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Aliskiren
• ACE inhibitors (such as Captopril, Lisinopril)
• Angiotensin II receptor blockers (such as Valsartan, Losartan)
• Corticosteroids (such as Prednisone)
• Diuretics (such as Furosemide)
• Leflunomide
• Probenecid
• Teriflunomide
• Vadadustat
• Lithium
• Pemetrexed