Ketorolac
Moderate pain (renal colic, headache, MSK), Opioid-sparing analgesia
Indications
- Moderate pain (renal colic, headache, MSK)
- Opioid-sparing analgesia
Adult dosing
- iv: dose: 15; unit: mg; route: IV; interval: q6h, max 5 days; fixed: true; im: dose: 30; unit: mg; route: IM; interval: q6h, max 5 days; fixed: true
Pediatric dosing
- iv: dose: 0.5; unit: mg/kg; maxDose: 15; maxDoseAbsolute: true; route: IV; interval: q6h; weightBased: true; pedNote: Avoid in children <2 years; im: dose: 1; unit: mg/kg; maxDose: 30; maxDoseAbsolute: true; route: IM; interval: q6h; weightBased: true; pedNote: Avoid in children <2 years
Contraindications
- Renal impairment
- Active GI bleed or peptic ulcer
- Coagulopathy or on anticoagulants
- Pregnancy (third trimester)
Clinical pearls
- 15mg IV is as effective as 30mg — no added benefit from higher dose (Motov et al.)
- Max 5 days total use — increased risk of GI bleed and renal injury with prolonged use
- Excellent for renal colic — comparable efficacy to opioids
Source and review
- Motov et al., Ann Emerg Med 2017. Last reviewed: 2024-10-01