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Do not use any ketorolac products (including this nasal spray, tablets, or injection) for more than a total of 5 days. Do not use this medication for minor or long-term painful conditions. This drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. This effect can occur without warning at any time while using this drug. Older adults may be at higher risk for this effect. Do not use this medication if you have stomach/intestinal problems (such as ulcers, bleeding). This drug may also increase your risk of serious bleeding in other parts of your body. Do not use this medication if you have bleeding or blood clotting problems, or are at high risk for bleeding. Nonsteroidal anti-inflammatory drugs (including ketorolac) may rarely increase the risk for a heart attack or stroke. This effect can happen at any time while using this drug but is more likely if you use it for a long time. The risk may be greater in older adults or if you have heart disease or increased risk for heart disease (for example, due to smoking, family history of heart disease, or conditions such as high blood pressure or diabetes). Talk to your doctor about the benefits and risks of using this drug. Do not use this drug right before or after heart bypass surgery (CABG) or before any surgery. It also should not be used during labor/delivery or in people with severe kidney problems or high risk for kidney problems. Stop using ketorolac and get medical help right away if you notice any of the following rare but serious side effects: bloody or black/tarry stools, stomach/abdominal pain, vomit that looks like coffee grounds, unusual or easy bruising/bleeding, chest/jaw/left arm pain, shortness of breath, unusual sweating, weakness on one side of the body, sudden vision changes, trouble speaking.

Mild and temporary irritation/discomfort in the nose may occur. Upset stomach, nausea, dizziness, or drowsiness may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high. Tell your doctor right away if you have any serious side effects, including: signs of kidney problems (such as change in the amount of urine), hearing changes (such as ringing in the ears), mental/mood changes, symptoms of heart failure (such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain). This drug may rarely cause serious (possibly fatal) liver disease. Stop using ketorolac and get medical help right away if you have any symptoms of liver damage, including: nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Some products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as valsartan, losartan), cidofovir, corticosteroids (such as prednisone), "water pills" (diuretics such as furosemide). Other medications can affect the removal of ketorolac from your body, which may affect how ketorolac works. Examples include leflunomide, probenecid, teriflunomide, vadadustat, among others. This medication may increase the risk of bleeding when used with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, pentoxifylline, among others. Do not use this medication with other forms of ketorolac, high doses of aspirin, or other NSAIDs. Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen or naproxen). These drugs are similar to ketorolac and may increase your risk of side effects if taken together. However, if your doctor has told you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor tells you not to. Ask your doctor or pharmacist for more details.