Is 30 mg of Toradol (Ketorolac) safe to administer with a Glomerular Filtration Rate (GFR) of 81?

Administration of Toradol (Ketorolac) with GFR of 81

Yes, 30 mg of Toradol (ketorolac) can be safely administered to a patient with a GFR of 81 mL/min/1.73m² as this represents normal kidney function. 1, 2

Renal Considerations for Ketorolac Administration

• Ketorolac is primarily eliminated by the kidneys, with approximately 91% of the dose excreted in urine 2
• No dose adjustment is required for patients with GFR >60 mL/min/1.73m², which includes your patient with GFR of 81 1, 2
• Ketorolac should be used with caution in patients with impaired renal function (GFR <60 mL/min/1.73m²) as it is a potent inhibitor of prostaglandin synthesis 2

Dosing Recommendations Based on Renal Function

• For GFR >60 mL/min/1.73m²: Standard dosing of ketorolac is appropriate 1, 2
• For GFR 30-60 mL/min/1.73m²: Consider dose reduction and careful monitoring 2
• For GFR <30 mL/min/1.73m²: Avoid use of NSAIDs including ketorolac 1, 2

Monitoring Considerations

• Even with normal renal function, monitor for signs of renal impairment during ketorolac therapy 2
• Watch for decreased urine output, increased serum creatinine, or fluid retention 2, 3
• Be alert for gastrointestinal adverse effects, which are common with NSAID use 2

Precautions and Contraindications

• Avoid ketorolac in patients with advanced renal impairment 2
• Use with caution in elderly patients, who may have age-related decline in renal function 2, 4
• Avoid concurrent use with other nephrotoxic medications when possible 2
• Ensure adequate hydration to minimize risk of renal complications 5

Risk Factors for Ketorolac-Induced Nephrotoxicity

• Pre-existing renal impairment 2, 3
• Volume depletion or dehydration 5
• Concurrent use of other nephrotoxic medications 2
• Advanced age 2, 4
• Post-surgical states with significant fluid shifts 3

While your patient with a GFR of 81 mL/min/1.73m² can safely receive 30 mg of ketorolac, always maintain vigilance for signs of renal dysfunction, as even patients with normal baseline renal function can develop acute kidney injury with NSAID use 5, 6, 7.