Recommended Intramuscular (IM) Dose of Toradol (Ketorolac) for Pain Management
The recommended intramuscular (IM) dose of Toradol (ketorolac) for pain management is 60 mg as a single dose for patients under 65 years of age, and 30 mg for patients who are 65 years or older, renally impaired, or weighing less than 50 kg. 1
Dosing Guidelines
- For patients under 65 years of age: 60 mg IM as a single dose 1
- For patients ≥65 years of age, renally impaired, or <50 kg: 30 mg IM as a single dose 1
- For multiple-dose treatment: 30 mg IM every 6 hours for patients <65 years (maximum daily dose: 120 mg) 1
- For multiple-dose treatment in elderly (≥65 years), renally impaired, or <50 kg patients: 15 mg IM every 6 hours (maximum daily dose: 60 mg) 1
- The intramuscular injection should be administered slowly and deeply into the muscle 1
Duration of Treatment
- Ketorolac treatment should not exceed 5 days 2, 1
- Patients should be switched to alternative analgesics as soon as possible 1
- The analgesic effect begins in approximately 30 minutes with maximum effect in 1-2 hours 1
- Duration of analgesic effect is typically 4-6 hours 1
Contraindications and Precautions
- Ketorolac should be avoided in patients with:
- Hypovolemia should be corrected prior to administration 1
- Ketorolac should not be mixed in a small volume with morphine sulfate, meperidine hydrochloride, promethazine hydrochloride, or hydroxyzine hydrochloride as this will result in precipitation 1
Common Side Effects
Clinical Considerations
- Ketorolac is useful for management of moderate to severe acute pain that requires analgesia at the opioid level 1
- It can be used alone or as an adjunct to traditional opioid analgesics 4
- Unlike opioids, ketorolac does not cause respiratory depression, nausea/vomiting, urinary retention, or sedation 5
- When combined with an opioid, ketorolac exhibits opioid-sparing effects, allowing for lower opioid dosages 5
- For breakthrough pain, do not increase the dose or frequency of ketorolac; consider supplementing with low doses of opioids if not contraindicated 1
Special Populations
- For pediatric patients, the recommended intraoperative single dose is 0.5-1 mg/kg 2, 5
- Ketorolac is not recommended for use in infants aged <1 year 5
Following these dosing guidelines will help ensure safe and effective pain management while minimizing the risk of adverse effects associated with ketorolac administration.