Maximum Safe Number of Toradol (Ketorolac) Injections Per Month
Ketorolac (Toradol) injections should not be used for more than 5 days total in a month, with a maximum daily dosage of 120 mg per day. 1
Dosing and Duration Guidelines
- Ketorolac is indicated for short-term management of moderate to severe pain, with strict limitations on duration of use 1
- Standard dosing for adults is 60 mg IM initially, followed by doses every 15-30 minutes as needed 1
- Maximum daily dosage should not exceed 120 mg 1
- Treatment duration should not exceed 5 days total 1, 2
- The 5-day limit applies to the total duration of use within a month, not the frequency of individual injections 2
Safety Considerations and Risks
- Prolonged use of ketorolac increases risk of serious adverse effects including 2, 3:
- Gastrointestinal bleeding
- Renal dysfunction
- Increased risk of cardiovascular events
- Edema and fluid retention
- Ketorolac should not be used prophylactically to prevent anticipated pain 2
- The medication should only be administered under direct supervision of a physician 2
- Ketorolac should be given in its lowest effective therapeutic dose 2
Contraindications
- Ketorolac is contraindicated in patients with 1:
- Aspirin/NSAID-induced asthma
- Pregnancy
- Cerebrovascular hemorrhage
- History of significant gastrointestinal bleeding
- Renal compromise
- Past history of complications related to NSAIDs
Special Populations
- Lower doses are recommended for elderly patients, those weighing less than 50 kg, and patients with impaired kidney function 4
- The elimination half-life increases in elderly patients and those with renal impairment 3, 5
- Ketorolac is not recommended for use in infants aged less than 1 year 6
Clinical Pearls
- Oral ketorolac should be used when possible instead of injectable forms 2
- Ketorolac should not be taken concurrently with other NSAIDs 2
- When combined with opioids, ketorolac exhibits marked opioid-sparing effects, allowing lower opioid dosages 6
- Ketorolac has a reversible inhibitory effect on platelet aggregation, which may increase bleeding time 6
Remember that while ketorolac is an effective analgesic, its use must be strictly limited to minimize serious adverse effects. The 5-day maximum duration within a month is a critical safety parameter that should not be exceeded.