Toradol (Ketorolac) Dosing Frequency
Toradol can be administered every 4 to 6 hours as needed, with a maximum of 120 mg per day, and total treatment duration must not exceed 5 days. 1, 2
Specific Dosing Regimens by Route
Intramuscular Administration
- 60 mg IM every 15 to 30 minutes for initial loading doses 1
- Maximum daily dose: 120 mg per day 1
- Treatment duration: not to exceed 5 days 1
Oral Administration (Continuation Therapy Only)
Oral ketorolac is ONLY indicated as continuation therapy following IV or IM dosing—it should never be used as initial treatment. 2
For patients age 17-64 years:
- 20 mg PO once (single transition dose), followed by 10 mg every 4 to 6 hours as needed 2
- Maximum: 40 mg per day (oral dosing) 2
For patients ≥65 years, renally impaired, or weight <50 kg:
- 10 mg PO once (single transition dose), followed by 10 mg every 4 to 6 hours as needed 2
- Maximum: 40 mg per day (oral dosing) 2
Critical Duration Limitation
The combined duration of IV/IM and oral ketorolac must not exceed 5 days total. 2, 3 This is a hard stop mandated by the FDA due to risks of gastrointestinal bleeding, renal compromise, and other NSAID-related complications 2, 3.
Practical Dosing Algorithm
- Never shorten the 4-6 hour dosing interval 2
- Use the minimum effective dose for each individual patient 2
- Count all routes together when calculating the 5-day maximum duration 2, 3
- Do not use prophylactically to prevent anticipated pain 3
Common Pitfalls to Avoid
- Do NOT use oral ketorolac as first-line therapy—it must follow parenteral administration 2
- Do NOT exceed 120 mg/day for IM dosing or 40 mg/day for oral continuation 2
- Do NOT use concurrently with other NSAIDs 3
- Do NOT extend treatment beyond 5 days regardless of route 2, 3
- Do NOT use in patients with GI bleeding history, renal compromise, or NSAID allergies 1, 3
Clinical Context
While ketorolac provides analgesia equivalent to morphine and meperidine for moderate-to-severe pain 4, 5, it has significant limitations including prolonged onset (30-60 minutes) and a substantial non-responder rate (>25% in most studies) 4. Ketorolac may be most useful as an adjunct to opioid analgesics rather than as monotherapy 4, 6.