For intramuscular (IM) or intravenous (IV) administration. IM injections should be given slowly and deeply into a large muscle. IV bolus injections should be administered over no less than 15 seconds. Ensure aseptic technique.

Ketorolac Tromethamine primarily acts by inhibiting prostaglandin synthesis through the inhibition of cyclooxygenase (COX-1 and COX-2) enzymes. This results in reduced inflammation, pain, and fever.

• •Active peptic ulcer disease, recent gastrointestinal bleeding or perforation, or history of these conditions.
• •Advanced renal impairment or risk of renal failure due to dehydration.
• •Hypersensitivity to ketorolac, aspirin, or other NSAIDs (e.g., aspirin-induced asthma, urticaria, or allergic-type reactions).
• •Concomitant use with other NSAIDs, aspirin, anticoagulants (e.g., warfarin, heparin), probenecid, or pentoxifylline.
• •Patients with cerebrovascular bleeding or other bleeding disorders.
• •During labor and delivery (due to effect on fetal circulation and inhibition of uterine contractions).
• •As prophylactic analgesic before major surgery with high risk of hemorrhage.
• •Neuraxial (epidural or intrathecal) administration.

Store at controlled room temperature (20-25°C or 68-77°F). Protect from light. Do not freeze.

Symptoms of overdose may include drowsiness, nausea, vomiting, epigastric pain, GI bleeding, lethargy, and anaphylactoid reactions. Management is primarily supportive and symptomatic. Gastric decontamination (e.g., activated charcoal) may be considered if taken orally, but for injection, supportive care (e.g., maintaining airway, monitoring vital signs, managing fluid and electrolyte balance) is crucial. Hemodialysis is not likely to remove significant amounts.

Pregnancy Category C (first and second trimester), Category D (third trimester). Contraindicated in the third trimester of pregnancy due to potential for premature closure of the fetal ductus arteriosus. Contraindicated during labor and delivery. Not recommended during breastfeeding as ketorolac is excreted in human milk and could have adverse effects on the nursing infant.