Ketorolac: a practical guide for short-term pain relief

Ketorolac is a strong NSAID used for short-term management of moderate to severe pain. It’s not a routine painkiller — doctors use it when something stronger than ibuprofen is needed but an opioid isn’t appropriate. Because ketorolac can cause serious bleeding and kidney problems, it’s usually limited to a few days of use.

How it’s used and common dosing

Ketorolac comes as an injection (IV or IM), tablets, and eye drops. The injection is common after surgery or for sudden bad pain; tablets are used when patients can’t get injections or as a follow-up. Ophthalmic ketorolac treats eye inflammation and allergic eye symptoms and has different dosing.

Typical adult dosing (general guidance — follow your prescriber): a single IV dose is often 30 mg, or 60 mg IM in some settings. After the initial injection, doctors commonly give 15–30 mg every 6 hours (injection) or switch to oral 10 mg every 4–6 hours as needed, not to exceed the daily limits. Total combined use (injectable plus oral) should not exceed 5 days because risk of harm rises quickly after that.

Elderly patients and people with low body weight need lower doses. If you have kidney disease, ketorolac may be avoided entirely or given at a much lower dose; your prescriber should adjust it based on kidney function.

Side effects and safety tips

Ketorolac can cause stomach bleeding, ulcers, and serious kidney problems. Watch for stomach pain, bloody or black stools, reduced urine output, swelling, or sudden shortness of breath — call your provider or seek urgent care if these happen. It can also increase bleeding risk, so don’t use it with blood thinners unless a doctor approves.

Avoid ketorolac if you have active peptic ulcer disease, recent gastrointestinal bleeding, severe kidney disease, or if you’re in the third trimester of pregnancy. Don’t mix it with other NSAIDs (aspirin, ibuprofen, naproxen) or with certain blood pressure medicines without medical advice. If you’re on ACE inhibitors, ARBs, diuretics, or anticoagulants, tell your prescriber before starting ketorolac.

For eye drops, follow the eyedrop schedule exactly. Systemic risks are much lower with ophthalmic use, but don’t use eye drops longer than directed and avoid contact lenses if advised.

Practical tips: always use the lowest effective dose for the shortest time, keep an eye on urine output and stool color, and never take ketorolac without a prescription. If pain persists after the prescribed short course, talk to your doctor instead of extending the medication yourself. If you have questions about interactions with other meds you take, bring a list to your appointment or ask your pharmacist.

Need more help? Ask your healthcare provider for a clear plan: why ketorolac is chosen, how long to take it, what side effects to watch for, and when to stop. That makes short-term pain control safer and more effective.