Non-selective NSAID
Ketorolac trometamol
Brand names: Toradol, Acuvail
Adult dose
Dose: IV/IM: 10mg every 4–6h (max 90mg/day, 60mg/day in elderly), max 2 days. PO: 10mg every 4–6h (max 40mg/day), max 7 days
Route: IV/IM/PO/Topical
Frequency: q4-6h
Clinical pearls
- Short-term moderate-severe acute pain — particularly post-operative
- Maximum duration: 5 days (IV/IM 2 days, then PO ≤7 days total)
Contraindications
- Active GI bleeding/peptic ulcer
- Severe HF/renal impairment
- NSAID hypersensitivity
- Bleeding disorder
- Recent surgery with high bleeding risk
- Asthma
- Pregnancy/breastfeeding
Side effects
- GI bleeding (high risk)
- Renal failure
- Bleeding (perioperative)
- Hypersensitivity
Interactions
- Anticoagulants/antiplatelets
- Other NSAIDs
- ACEi/ARB
- Lithium
- Methotrexate
Monitoring
- U&E
- FBC
- BP
Reference: BNF; MHRA; https://bnf.nice.org.uk/drugs/ketorolac-trometamol/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
Pathways
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
- Syncope Assessment · ESC 2018 Syncope Guidelines; NICE NG109
- Acute Chest Pain · NICE CG95; ESC 2023 ACS Guidelines