From the Guidelines
If you have a ketorolac allergy, you should avoid receiving ketorolac injection due to the risk of anaphylaxis, a potentially life-threatening allergic reaction, as recommended by the most recent and highest quality study 1.
Ketorolac Allergy Symptoms
Symptoms of a ketorolac allergy may include:
- Hives
- Rash
- Itching
- Swelling (especially of the face, tongue, or throat)
- Severe dizziness
- Difficulty breathing If you experience these symptoms after receiving ketorolac, seek immediate medical attention as this could indicate anaphylaxis.
Alternative Pain Medications
Alternative pain medications that may be used instead include:
- Acetaminophen
- Certain opioids
- Other classes of NSAIDs if your allergy is specific to ketorolac rather than all NSAIDs Ketorolac allergies occur because your immune system mistakenly identifies the drug as harmful and releases chemicals that cause allergy symptoms.
Importance of Informing Healthcare Providers
You should inform all healthcare providers about this allergy and wear a medical alert bracelet to ensure your safety in case of an emergency. Cross-reactivity with other NSAIDs is possible, so your doctor may recommend allergy testing to determine the extent of your sensitivities, as suggested by 1 and 1.
Anaphylaxis Diagnosis and Treatment
Anaphylaxis can be diagnosed using the NIAID/FAAN criteria, which include acute onset of symptoms, involvement of two or more body systems, and exposure to a known allergen trigger 1. Treatment of anaphylaxis typically involves administration of epinephrine, which can be life-saving in severe cases, as recommended by 1.
From the Research
Ketorolac Allergy Injection
- Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) that can cause anaphylaxis, a life-threatening systemic allergic hypersensitivity reaction 2, 3, 4, 5.
- Anaphylaxis can occur after oral or intravenous administration of ketorolac, and symptoms include swelling, difficulty breathing, and hypotension 2, 3, 4, 5.
- Treatment for anaphylaxis involves medications like epinephrine, hydrocortisone, and pheniramine, as well as oxygen therapy and follow-up care 2, 4.
- Allergic reactions to ketorolac are rare, but can be life-threatening and should be carefully monitored 3, 4, 5.
- A detailed medical history, laboratory investigations, and appropriate medication are important in managing anaphylactic reactions 2, 4.
Risk Factors
- Patients with a history of allergic reactions to NSAIDs, such as ibuprofen, may be at increased risk of anaphylaxis to ketorolac 4.
- The risk of anaphylaxis may be higher in patients who receive high doses of ketorolac or have a history of drug allergy 6, 5.
Clinical Presentation
- Symptoms of anaphylaxis to ketorolac can include periorbital swelling, itching, difficulty breathing, and hypotension 2, 3, 4, 5.
- Urticaria-like skin lesions, including rashes and wheals, can also occur 4.
- Tachycardia and breathing difficulty with oxygen desaturation can develop after injection of ketorolac 4.