From the FDA Drug Label
The maximum daily dose for patients <65 years of age should not exceed 120 mg The maximum daily dose for patients ≥65 years of age, renally impaired patients, and patients less than 50 kg (110 lbs) should not exceed 60 mg Multiple-Dose Treatment (Intravenous or Intramuscular) Patients <65 years of age: The recommended dose is 30 mg ketorolac tromethamine injection every 6 hours. Multiple-Dose Treatment (Intravenous or Intramuscular) For patients ≥65 years of age, renally impaired patients, and patients less than 50 kg (110 lbs): The recommended dose is 15 mg ketorolac tromethamine injection every 6 hours.
The maximum dose of Toradol (Ketorolac) administered intravenously (IV) and intramuscularly (IM) is:
- 120 mg per day for patients less than 65 years of age, with a dose of 30 mg every 6 hours.
- 60 mg per day for patients 65 years of age or older, renally impaired, or less than 50 kg, with a dose of 15 mg every 6 hours 1.
From the Research
The maximum dose of Ketorolac (Toradol) is 30 mg for intravenous (IV) administration and 60 mg for intramuscular (IM) administration as a single dose, as supported by the most recent study 2.
Key Considerations
- For ongoing treatment, the maximum daily dose should not exceed 120 mg per day, regardless of the route of administration, to minimize the risk of serious gastrointestinal and renal adverse effects.
- Treatment duration should be limited to a maximum of 5 days due to the risk of serious gastrointestinal and renal adverse effects.
- Elderly patients, those with renal impairment, or those weighing less than 50 kg should receive reduced doses, typically half the standard dose, as evidenced by studies such as 3.
Mechanism and Precautions
- Ketorolac is a potent non-steroidal anti-inflammatory drug (NSAID) that works by inhibiting prostaglandin synthesis, providing effective pain relief for moderate to severe pain.
- It's essential to ensure adequate hydration during treatment and to avoid concurrent use with other NSAIDs or in patients with certain conditions like advanced renal disease, risk of bleeding, or history of peptic ulcer disease, as highlighted in studies such as 4 and 5.
Administration and Monitoring
- The intravenous route is preferred for initial administration, followed by oral or intramuscular routes as needed, with dosing intervals of every 6 hours, as suggested by 6.
- Monitoring for adverse effects, such as gastrointestinal bleeding, renal impairment, and bleeding tendencies, is crucial during treatment with ketorolac, as noted in 2 and 5.