Adults

Oral: Typically 10 mg every 4-6 hours as needed, not to exceed 40 mg/day for a maximum of 5 days. A 1 mg tablet would require multiple tablets to reach the usual therapeutic dose, or it might be intended for a very specific low-dose regimen.

Elderly

Lower doses may be required, generally not exceeding 20 mg/day, due to potential impairment in renal function and increased susceptibility to adverse effects.

Renal_impairment

Contraindicated in moderate to severe renal impairment. For mild impairment, dosage reduction is necessary; maximum 20 mg/day.

Onset

Analgesia usually begins within 1 hour after oral administration.

Excretion

Primarily renal, with approximately 90% of a dose excreted in the urine and a small amount in feces.

Half life

Approximately 4-6 hours, but may vary based on age and renal function.

Absorption

Rapid and complete oral absorption. Peak plasma concentrations are typically achieved within 30-60 minutes.

Metabolism

Primarily hepatic, through hydroxylation and conjugation. Main metabolite is p-hydroxyketorolac.

Lithium

Ketorolac may increase plasma lithium levels, leading to lithium toxicity.

Methotrexate

Increased methotrexate toxicity, especially with high doses of methotrexate.

ACE inhibitors/ARBs

Increased risk of renal impairment, especially in elderly or volume-depleted patients.

Other NSAIDs/Aspirin

Concomitant use increases the risk of gastrointestinal adverse events.

Warfarin/Anticoagulants

Increased risk of serious bleeding.

Diuretics (e.g., Furosemide, Thiazides)

Reduced diuretic and antihypertensive effects, potential for renal impairment.