From the Guidelines
Ketorolac should not be placed under the tongue. Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) that is only approved for oral tablet, intramuscular injection, or intravenous administration. The oral tablets are designed to be swallowed whole with water, not dissolved under the tongue. Sublingual administration (under the tongue) could lead to improper absorption, local irritation of the mucous membranes, and potentially reduced effectiveness of the medication. Additionally, ketorolac has a bitter taste that would make sublingual administration unpleasant.
According to the most recent and highest quality study, the use of ketorolac is recommended as part of an opioid-sparing regimen in children and adolescents after surgery 1. However, this study does not support the use of ketorolac sublingually. In fact, the study suggests that ketorolac is effective in reducing postoperative pain and opioid requirements when administered intravenously.
If you're having difficulty swallowing tablets, speak with your healthcare provider about alternative formulations or medications. Ketorolac is typically prescribed for short-term management of moderate to severe pain (usually 5 days or less) and should only be used as directed by your healthcare provider due to its potential for serious side effects, including gastrointestinal bleeding and kidney problems.
Some key points to consider when using ketorolac include:
- It is not approved for sublingual administration
- It should be used with caution in patients with marginal kidney function
- It can be associated with acute kidney injury
- It is typically prescribed for short-term management of moderate to severe pain
- It should only be used as directed by a healthcare provider due to its potential for serious side effects.
Overall, the evidence suggests that ketorolac should not be placed under the tongue, and alternative formulations or administration methods should be considered if necessary.
From the Research
Administration of Ketorolac
- There is no direct evidence in the provided studies to suggest that ketorolac can be placed under the tongue 2, 3, 4, 5, 6.
- The studies discuss various administration methods, including oral, intramuscular, intravenous, and topical ophthalmic solution, but do not mention sublingual administration 2, 3, 4.
- Ketorolac is available in different forms, but the provided studies do not specify sublingual administration as a recommended or studied method 5, 6.
- One study mentions ketorolac nasal spray, which is a different administration method, but it is not related to sublingual administration 6.
Available Administration Methods
- Oral administration: discussed in several studies as an effective method for pain management 2, 3, 4.
- Intramuscular administration: mentioned as a method that provides analgesia equivalent to commonly used doses of meperidine and morphine 3.
- Intravenous administration: studied as a method for pain management, but its utility is limited due to a prolonged onset to analgesic action 3.
- Topical ophthalmic solution: mentioned as a form of administration, but not studied in the context of pain management 4.
- Nasal spray: discussed as a method for short-term management of moderate to moderately severe pain requiring analgesia at the opioid level 6.