Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Ketorolac.
HEALTH CANADA ADVISORY
June 8, 2021
Health Canada has issued new information concerning the use of non-steroidal anti-inflammatory drugs (NSAIDs). To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
A previous advisory on non-steroidal anti-inflammatory drugs (NSAIDs) was issued on October 30, 2020.
Allergic reactions: If you have had a reaction to acetylsalicylic acid (ASA) or other NSAIDs (e.g., ibuprofen, Ketoprofen, diclofenac) that included a runny nose, itchy skin rash, nasal polyps, or shortness of breath and wheezing, you should not take Ketorolac. Get immediate medical attention if you experience symptoms of a severe allergic reaction (e.g., hives, difficulty breathing, wheezing, or swelling of the face, tongue, or throat).
Bladder symptoms: Ketorolac can cause bladder symptoms such as frequent or painful urination and blood in urine. If you develop these symptoms, stop taking Ketorolac and contact your doctor immediately.
Bleeding: Ketorolac may cause the platelets in the blood to not stick together very well. This can make it difficult to stop cuts from bleeding. If you have a condition where your blood does not clot easily, or if you are taking medications to prevent your blood from clotting, discuss with your doctor how Ketorolac may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Ketorolac, and whether any special monitoring is needed.
If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.
Blood pressure: Like other NSAIDs, ketorolac can cause increased blood pressure, which may contribute to other heart conditions. If you have high blood pressure, discuss with your doctor how Ketorolac may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Ketorolac, and whether any special monitoring is needed.
Drowsiness and dizziness: Ketorolac can cause drowsiness or dizziness. Do not drive or operate machinery until you are sure that Ketorolac does not affect your ability to do these safely.
Fertility: As with other NSAIDs, Ketorolac may make it more difficult for a couple to conceive if the woman is taking ketorolac. Stopping the medication allows the body's chemistry to return to normal which often resolves this issue.
Heart conditions: Ketorolac can cause fluid retention, which will make symptoms of certain heart conditions worse. If you have heart failure, high blood pressure, or other medical conditions that increase your risk of fluid retention (e.g., kidney problems), discuss with your doctor how Ketorolac may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Ketorolac, and whether any special monitoring is needed.
Heart problems: Like other NSAID medications, ketorolac may increase the risk of heart attacks, strokes, and Blood Clots. If you have any risk factors for heart problems, such as high blood pressure, High Cholesterol, Diabetes, peripheral arterial disease, heart failure, or Coronary Artery Disease, discuss with your doctor how Ketorolac may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Ketorolac, and whether any special monitoring is needed.
Infection: Ketorolac may mask signs of infection such as fever or muscle aches. If you notice other symptoms of infection (e.g., painful or frequent urination, sore throat, cough), contact your doctor.
Kidney function: Kidney Disease or reduced kidney function may cause Ketorolac to build up in the body, causing side effects. Ketorolac can also affect kidney function. You have a higher risk of developing kidney problems if you are a senior, take diuretics (water pills; e.g., Hydrochlorothiazide, Furosemide), or already have kidney disease, liver disease, or heart failure. Your doctor may monitor your kidney function with blood tests if you take Ketorolac.
Liver function: Ketorolac may affect your liver function or cause liver problems. If you experience symptoms of liver problems (e.g., nausea, vomiting, feeling tired, yellowing of the skin or eyes), contact your doctor immediately. If you have liver problems, discuss with your doctor how Ketorolac may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Ketorolac, and whether any special monitoring is needed. People with severely reduced liver function or have active liver disease should not take Ketorolac.
Long-term use: Long-term use of ketorolac (beyond 5 to 7 days for the tablets, or 2 days for the injection) is not recommended, as the risk of side effects increases with the length of treatment.
Potassium levels: Ketorolac may cause high blood potassium levels. If you are a senior, have diabetes or kidney failure, or are taking beta-blockers (e.g., Metoprolol, Atenolol), angiotensin converting enzyme (ACE) inhibitors (e.g., Ramipril, Enalapril), or some diuretics (e.g., triamterene, Amiloride), you are more at risk of high blood potassium. Because extremely high blood potassium levels can contribute to other conditions, such as heart problems, your doctor will monitor your potassium level with blood tests while you are taking Ketorolac.
Ulcers and bleeding in the stomach and intestines: Ketorolac may cause stomach ulcers and bleeding from the stomach. These complications can occur at any time and are sometimes severe.
If you have had a stomach or intestinal ulcer, diverticulosis, Crohn's disease, or ulcerative colitis, discuss with your doctor how Ketorolac may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Ketorolac, and whether any special monitoring is needed.
If you experience symptoms of an ulcer or other stomach problems (e.g., stomach or abdominal pain, black stools, bloody or coffee-ground-like vomit, weakness) contact your doctor immediately or get immediate medical attention.
Pregnancy: Ketorolac should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Ketorolac, contact your doctor immediately. It must not be used during the last 3 months of pregnancy as it may cause heart and kidney problems for the developing baby and cause prolonged labour with excessive bleeding during delivery.
Breast-feeding: Ketorolac passes into breast milk. If you are a breast-feeding mother and are taking ketorolac, it may affect your baby. Breast-feeding is not recommended while you are taking ketorolac.
Children: The safety and effectiveness of using Ketorolac have not been established for children less than 18 years of age.
Seniors: Seniors have a higher risk of side effects with Ketorolac. If you are a senior, your doctor will closely monitor you for side effects and may prescribe a lower dose than usually recommended.
