ketorolac (nasal)

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Pronunciation: KEE toe ROLE ak (NAY sul)

Brand: Sprix

What is the most important information I should know about ketorolac nasal?

You should not use ketorolac nasal if you have severe kidney disease, a bleeding or blood clotting disorder, bleeding in your brain, a stomach ulcer or history of stomach bleeding, or if you are breast-feeding a baby. Do not use this medicine for longer than 5 days.

Ketorolac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ketorolac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ketorolac nasal, especially in older adults.

Pentoxifylline or probenecid can interact with ketorolac nasal and should not be used at the same time.

What is ketorolac nasal?

Ketorolac is a nonsteroidal anti inflammatory drug (NSAID). This medicine works by reducing substances in the body that cause pain, fever, and inflammation.

Ketorolac nasal (for the nose) is used short-term (5 days or less) to treat moderate to severe pain.

Ketorolac may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using ketorolac nasal?

Ketorolac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking this medicine.

Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ketorolac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ketorolac nasal, especially in older adults.

You should not use this medicine if you are allergic to ketorolac, or if you have:

  • severe kidney disease;
  • a bleeding or blood clotting disorder;
  • a closed head injury or bleeding in your brain;
  • a stomach ulcer, perforation, or a history of stomach or intestinal bleeding;
  • if you are breast-feeding a baby; or
  • if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

Pentoxifylline or probenecid can interact with ketorolac nasal and should not be used at the same time.

Do not use ketorolac nasal if you are already taking aspirin or other NSAIDs, or using other forms of ketorolac (such as injections or pills you take by mouth).

To make sure ketorolac nasal is safe for you, tell your doctor if you have:

  • heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;
  • a history of heart attack, stroke, or blood clot;
  • a history of stomach ulcers or bleeding;
  • ulcerative colitis or Crohn's disease;
  • asthma;
  • liver or kidney disease;
  • fluid retention; or
  • if you have recently had surgery.

Using ketorolac nasal during the last 3 months of pregnancy may harm the unborn baby. Ketorolac may also increase the risk of uterine bleeding and is not for use during labor and delivery. Tell your doctor if you are pregnant.

Ketorolac nasal can pass into breast milk and may harm a nursing baby. Do not breast-feed while using this medicine.

Ketorolac nasal is not approved for use by anyone younger than 18 years old.

How should I use ketorolac nasal?

Follow all directions on your prescription label. Do not use this medicine in larger amounts or for longer than recommended. Use the lowest dose that is effective in treating your condition.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Ketorolac nasal is usually given every 6 to 8 hours. Follow your doctor's instructions.

To use the ketorolac nasal spray:

  • Gently blow your nose before using the nasal spray.
  • The first time you use a new bottle, remove the clip and plastic cover and prime the unit by pumping 5 sprays into the air, away from your face, until a fine mist appears.
  • Tilt your head forward slightly and insert the tip of bottle into your nostril, pointing it away from the center of your nose. Breathe through your mouth while spraying gently into your nostril. Do not inhale or sniff while spraying. If your nose runs, gently sniff to keep the nasal spray from leaking out.
  • Use only the number of sprays prescribed by your doctor.
  • Put the plastic cap back on the bottle and store it in a dry place, out of direct sunlight.

Avoid getting this medication in your eyes. If this does happen, rinse with water or saline solution. Call your doctor if you have eye irritation for longer than 1 hour.

Do not use this medication for longer than 5 days unless your doctor has told you to.

Each bottle of this medicine contains 8 sprays for use within a 24-hour period. Throw the bottle away within 24 hours after your first use, even if there is still some medicine left in the bottle.

Store the unopened nasal spray bottles in a refrigerator. Do not freeze.

After opening a bottle, store it at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using ketorolac nasal?

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid taking aspirin or other NSAIDs while you are using ketorolac nasal.

Ask a doctor or pharmacist before using any cold, allergy, or pain medication. Many medicines available over the counter contain aspirin or other medicines similar to ketorolac. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen.

What are the possible side effects of ketorolac nasal?

Get emergency medical help if you have signs of an allergic reaction: sneezing, runny or stuffy nose; wheezing or trouble breathing; hives; swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have heart attack symptoms --chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating; or signs of a stroke --sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance.

Stop using ketorolac and call your doctor at once if you have:

  • shortness of breath (even with mild exertion);
  • swelling or rapid weight gain;
  • the first sign of any skin rash, no matter how mild;
  • signs of stomach bleeding --bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
  • liver problems --nausea, upper stomach pain, itching, tired feeling, flu-like symptoms, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • kidney problems --little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath;
  • low red blood cells (anemia) --pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or
  • severe skin reaction --fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • pain or irritation in your nose;
  • runny nose;
  • watery eyes;
  • throat irritation; or
  • mild rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect ketorolac nasal?

Ask your doctor before using ketorolac if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • lithium;
  • methotrexate;
  • heparin or warfarin (Coumadin, Jantoven);
  • antipsychotic medicine;
  • heart or blood pressure medication, including a diuretic or "water pill";
  • seizure medicine (carbamazepine, phenytoin); or
  • steroid medicine (such as prednisone).

This list is not complete. Other drugs may interact with ketorolac nasal, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about ketorolac nasal.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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