What is the recommended dosing frequency for Toradol (Ketorolac) 10 mg intramuscular (IM) injections in a healthy 18-year-old female with no known medical history?

Ketorolac IM Dosing Frequency for an 18-Year-Old Female

For an 18-year-old female, ketorolac 10 mg IM should not be given—the correct IM dose is 60 mg every 6 hours (not 10 mg), with a maximum daily dose of 120 mg and treatment duration not exceeding 5 days. 1

Correct Dosing Parameters

The FDA-approved dosing for ketorolac IM in patients under 65 years of age is:

• Single-dose regimen: 60 mg IM as one-time administration 1
• Multiple-dose regimen: 30 mg IM every 6 hours, with maximum daily dose of 120 mg 1
• Maximum treatment duration: 5 days total (combined parenteral and oral therapy) 1

The 10 mg dose you mentioned does not align with standard IM dosing protocols. The 10 mg formulation is typically reserved for oral administration after transitioning from parenteral therapy. 2

Dosing Frequency Specifics

For multiple-dose treatment in a healthy 18-year-old female:

• Administer 30 mg IM every 6 hours (not more frequently) 1
• This allows for a maximum of 4 doses per 24-hour period (120 mg total daily) 1
• The analgesic effect begins in approximately 30 minutes with maximum effect at 1-2 hours and duration of 4-6 hours 1

Critical Safety Considerations

Duration limitation is non-negotiable: Ketorolac therapy must not exceed 5 days due to increased risk of serious adverse events including gastrointestinal bleeding, perforation, and renal impairment with prolonged use. 1, 3

Contraindications to verify before administration:

• History of aspirin/NSAID-induced asthma 2, 4
• Active or history of peptic ulcer disease or GI bleeding 4, 5
• Cerebrovascular hemorrhage 2, 4
• Concurrent anticoagulant use 4, 5
• Pregnancy (ketorolac is contraindicated) 2, 1

Baseline monitoring recommended:

• Renal function 5
• Complete blood count 5
• Blood pressure 5

Common Pitfalls to Avoid

Do not increase dose or frequency for breakthrough pain—instead, consider supplementing with low-dose opioids if not contraindicated. 1

Do not mix ketorolac in a syringe with morphine, meperidine, promethazine, or hydroxyzine, as this causes precipitation. 1

Do not use concurrent NSAIDs or SSRIs/SNRIs due to increased risk of adverse events and bleeding. 5

The incidence of serious adverse events, particularly GI bleeding and renal impairment, increases significantly with high doses and prolonged therapy beyond 5 days, especially in vulnerable populations. 3 While your patient is young and presumably healthy, strict adherence to dosing limits and duration restrictions is essential to minimize these risks. 3, 6