From the Research
Ketorolac (Toradol) dosing for adults is typically 15-30 mg IV/IM, with a maximum single dose of 30 mg, and the most recent evidence suggests that doses as low as 10 mg may be effective for pain relief 1. The dosing can be given every 6 hours, but treatment duration should not exceed 5 days total due to risk of adverse effects. The oral dosing is typically 10 mg every 4-6 hours with a maximum daily dose of 40 mg. Dose reduction is necessary in elderly patients (those over 65 years), patients with renal impairment (reduce by 50% if creatinine clearance <30 mL/min), and those weighing less than 50 kg. Ketorolac is a potent non-steroidal anti-inflammatory drug (NSAID) that works by inhibiting prostaglandin synthesis, providing effective pain relief for moderate to severe pain. It carries risks of gastrointestinal bleeding, renal impairment, and cardiovascular events, particularly with prolonged use, which is why the duration limitation is important. Some key points to consider when using ketorolac include:
- The risk of adverse effects increases with higher doses and longer treatment duration 2, 3
- Ketorolac may be used in combination with opioids to reduce opioid requirements and minimize opioid-related adverse effects 4, 3
- The use of ketorolac in spinal fusion surgery has been shown to be safe and effective in reducing postoperative pain and opioid use 5
- Recent studies suggest that lower doses of ketorolac (10 mg) may be effective for pain relief, which could help minimize the risk of adverse effects 1.