Ketorolac: what it treats and how to stay safe

Ketorolac is a strong nonsteroidal anti-inflammatory drug (NSAID) often used for short-term relief of moderate to severe pain. You’ll usually see it in hospitals as an IV or IM injection after surgery, but it can also be given by mouth in some cases. It works fast and can reduce the need for opioids, but it also carries risks that make short use and close monitoring essential.

Quick facts you need to know

Ketorolac reduces pain and inflammation by blocking enzymes that make inflammatory chemicals. Doctors favor it for 24–72 hours of post-operative pain control or for acute painful conditions where short-term strong pain relief is needed. It is not a long-term drug: most guidelines cap total use at 5 days because the chance of bleeding, stomach ulcers, and kidney problems rises with longer use.

Common side effects include stomach pain, nausea, dizziness, headache, and swelling. More serious risks are gastrointestinal bleeding, kidney injury, increased blood pressure, and allergic reactions. People with active peptic ulcers, recent bleeding, severe kidney disease, or those on blood thinners are usually told to avoid ketorolac. It’s also not used during labor or in late pregnancy because it can affect the baby’s circulation.

How to use ketorolac safely

Always follow your prescriber’s instructions. Typical hospital practice gives a single IV or IM dose and may repeat one or two doses, switching to oral only if needed and safe. Ask your provider about your kidney function and whether you’re on any blood thinners, ACE inhibitors, ARBs, diuretics, or SSRIs — those drugs can raise bleeding or kidney risks when mixed with NSAIDs.

Check with your doctor before taking other NSAIDs or aspirin together with ketorolac — combining them increases side effects without extra benefit. Avoid heavy alcohol while using it, since alcohol ups bleeding risk. If you notice black stools, vomit that looks like coffee grounds, severe stomach pain, new swelling, fainting, or trouble breathing, get medical help right away.

Thinking about alternatives? For mild pain, acetaminophen is often safer for short-term use. For severe pain, doctors may prefer short opioid courses or regional anesthesia techniques instead of repeated NSAID doses. Ketorolac can be a helpful opioid-sparing agent in the right situation, but it must be used for a limited time and with careful checks.

Lastly, availability and exact dosing can vary by country and hospital protocol. If you’re prescribed ketorolac, ask how long you should take it, what dose is planned, and whether any blood tests or kidney checks are needed. A short chat with your clinician can prevent a lot of avoidable problems while letting you get reliable pain relief.