Before Using

Drug information provided by: Merative, Micromedex®

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of ketorolac nasal spray in the pediatric population. Use is not recommended in children younger than 2 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ketorolac nasal spray in the elderly. However, because of this medicine's toxicity, it should be used with caution in the elderly, after less toxic alternatives have been considered or found ineffective. Recommended doses should not be exceeded, and the patient should be carefully monitored during treatment. In addition, elderly patients are more likely to have age-related heart, kidney, liver, or stomach or bowel problems, which may require caution and an adjustment in the dose for patients receiving ketorolac nasal spray.

Breastfeeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Aceclofenac
  • Acemetacin
  • Amtolmetin Guacil
  • Aspirin
  • Bromfenac
  • Bufexamac
  • Celecoxib
  • Choline Salicylate
  • Clonixin
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Droxicam
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Ibuprofen
  • Indomethacin
  • Ketoprofen
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Pentoxifylline
  • Phenylbutazone
  • Piketoprofen
  • Piroxicam
  • Probenecid
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • Sulfasalazine
  • Sulindac
  • Tenoxicam
  • Tiaprofenic Acid
  • Tolfenamic Acid
  • Tolmetin
  • Valdecoxib

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abciximab
  • Acenocoumarol
  • Amiloride
  • Amineptine
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Anagrelide
  • Apixaban
  • Ardeparin
  • Argatroban
  • Bemetizide
  • Bemiparin
  • Bendroflumethiazide
  • Benzthiazide
  • Betamethasone
  • Betrixaban
  • Bivalirudin
  • Budesonide
  • Bumetanide
  • Cangrelor
  • Certoparin
  • Chlorothiazide
  • Chlorthalidone
  • Cilostazol
  • Citalopram
  • Clomipramine
  • Clopamide
  • Clopidogrel
  • Cortisone
  • Cyclopenthiazide
  • Cyclosporine
  • Cyclothiazide
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Deflazacort
  • Desipramine
  • Desirudin
  • Desmopressin
  • Desvenlafaxine
  • Dexamethasone
  • Diazoxide
  • Dibenzepin
  • Digoxin
  • Dipyridamole
  • Dothiepin
  • Doxepin
  • Duloxetine
  • Edoxaban
  • Emtricitabine
  • Enoxaparin
  • Eplerenone
  • Epoprostenol
  • Eptifibatide
  • Escitalopram
  • Ethacrynic Acid
  • Etozolin
  • Feverfew
  • Fluocortolone
  • Fluoxetine
  • Fluvoxamine
  • Fondaparinux
  • Furosemide
  • Ginkgo
  • Gossypol
  • Heparin
  • Hydrochlorothiazide
  • Hydrocortisone
  • Hydroflumethiazide
  • Iloprost
  • Imipramine
  • Indapamide
  • Inotersen
  • Lepirudin
  • Levomilnacipran
  • Lithium
  • Lofepramine
  • Meadowsweet
  • Melitracen
  • Melphalan
  • Methotrexate
  • Methyclothiazide
  • Methylprednisolone
  • Metolazone
  • Milnacipran
  • Nadroparin
  • Nefazodone
  • Nortriptyline
  • Opipramol
  • Paramethasone
  • Parnaparin
  • Paroxetine
  • Pemetrexed
  • Pentosan Polysulfate Sodium
  • Phenindione
  • Phenprocoumon
  • Piretanide
  • Polythiazide
  • Potassium Citrate
  • Prasugrel
  • Prednisolone
  • Prednisone
  • Protein C
  • Protriptyline
  • Quinethazone
  • Reviparin
  • Rivaroxaban
  • Selexipag
  • Sertraline
  • Sibutramine
  • Spironolactone
  • Sulfinpyrazone
  • Sulodexide
  • Tacrolimus
  • Tenofovir Alafenamide
  • Tenofovir Disoproxil Fumarate
  • Tianeptine
  • Ticagrelor
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Torsemide
  • Trazodone
  • Treprostinil
  • Triamterene
  • Trichlormethiazide
  • Trimipramine
  • Venlafaxine
  • Vilazodone
  • Vorapaxar
  • Vortioxetine
  • Warfarin
  • Xipamide

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acebutolol
  • Atenolol
  • Azilsartan
  • Azilsartan Medoxomil
  • Benazepril
  • Betaxolol
  • Bisoprolol
  • Candesartan
  • Captopril
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Enalapril
  • Enalaprilat
  • Eprosartan
  • Esmolol
  • Fosinopril
  • Irbesartan
  • Labetalol
  • Levobunolol
  • Lisinopril
  • Losartan
  • Metipranolol
  • Metoprolol
  • Moexipril
  • Nadolol
  • Nebivolol
  • Olmesartan
  • Oxprenolol
  • Penbutolol
  • Perindopril
  • Pindolol
  • Propranolol
  • Quinapril
  • Ramipril
  • Sotalol
  • Spirapril
  • Telmisartan
  • Timolol
  • Trandolapril
  • Valsartan

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergy to ethylenediamine tetraacetic acid (EDTA) or
  • Allergy to aspirin or other non-steroidal anti-inflammatory medicines (NSAIDs) or
  • Aspirin-sensitive asthma, history of or
  • Bleeding problems or
  • Kidney disease, severe (including kidney failure) or
  • Major surgery, prior to or
  • Stomach ulcers, bleeding, or perforation, active or recent or
  • Use for pain relief of labor or childbirth—Should not be used in patients with these conditions.
  • Anemia or
  • Blood clotting problems or
  • Congestive heart failure or
  • Crohn's disease, history of or
  • Edema (fluid retention or body swelling) or
  • Heart attack, recent or history of or
  • Heart disease or
  • Hyperkalemia (high potassium in the blood) or
  • Hypertension (high blood pressure) or
  • Kidney disease, or history of or
  • Liver disease, or history of or
  • Stroke, history of or
  • Ulcerative colitis, history of—Use with caution. May make these conditions worse.
  • Heart surgery (eg, coronary artery bypass graft [CABG])—Should not be used to relieve pain right before or after the surgery.