Precautions and Warnings With Ketorolac Nasal Spray

Specific Ketorolac Nasal Spray Precautions and Warnings

Some warnings and precautions to be aware of with this medication include the following:
 
  • Ketorolac nasal spray is meant for short-term pain relief. This medication should not be used for more than five days. Using ketorolac nasal spray for longer than five days increases your risk for serious side effects.
     
  • Ketorolac nasal spray and other NSAIDs can cause serious and potentially life-threatening stomach and intestinal problems, including bleeding, ulcers, or holes (perforations). The chance of these problems occurring is higher in older adults and in people who smoke, drink alcohol, have poor health, or take certain other medications (see Drug Interactions With Ketorolac Nasal Spray). The risk is also greater when using any NSAID for a long period of time.
     
  • People with a history of stomach or intestinal ulcers (peptic ulcer) or bleeding should not use ketorolac nasal spray. Bleeding problems can sometimes occur without warning or symptoms. Therefore, it is very important that you contact your healthcare provider immediately if you experience any signs or symptoms of ulcers or bleeding, such as:
     
    • Black, sticky, tarry stools
    • Blood in the urine or stools
    • Abdominal (stomach) pain and indigestion
    • Vomiting blood.
 
  • Using ketorolac nasal spray or other NSAIDs may cause kidney damage. The chance of kidney damage is higher in older adults and people who have kidney disease, heart failure, or liver problems. It is also more common in people taking diuretics or ACE inhibitors.

Make sure to drink plenty of fluids while using ketorolac nasal spray, as staying well hydrated can help decrease your risk for this side effect. Contact your healthcare provider if you notice a significant decrease in the amount you urinate while using this medication.

  • Ketorolac nasal spray and other NSAIDs increase the risk for serious and potentially life-threatening cardiovascular problems, including heart attacks and strokes. People who take NSAIDs for a long period of time or who already have heart disease are at an increased risk for these problems. It is very important that you stop using ketorolac nasal spray and seek immediate medical care if you experience any signs of a heart attack or stroke, including:
     
    • Chest pain
    • Shortness of breath
    • Weakness
    • Slurred speech.
 
  • Ketorolac nasal spray and other NSAIDs may cause congestive heart failure or swelling (edema). Contact your healthcare provider if you notice unexplained weight gain or swelling. If you have heart failure, high blood pressure (hypertension), or other conditions that may cause edema, it's important that your healthcare provider knows so he or she can monitor you closely when you use ketorolac nasal spray.
     
  • NSAIDs such as ketorolac nasal spray may cause liver problems, which can range from a mild increase in certain liver enzymes to life-threatening liver failure. Your healthcare provider may monitor your liver function with a blood test before you start using ketorolac nasal spray and during your treatment period. You should stop using this medicine and seek immediate medical treatment if you notice signs of liver problems, such as:
     
    • Nausea
    • Fatigue
    • Excessive tiredness
    • Itching
    • Upper stomach pain
    • Flu-like symptoms
    • Yellowing of the skin or whites of the eyes (jaundice).
 
  • NSAIDs such as ketorolac nasal spray have been reported to cause allergic reactions. Stop using this medicine and seek immediate medical attention if you notice hives, an unexplained rash, difficulty breathing, or swelling of the face and throat.
     
  • In rare cases, people using ketorolac nasal spray may develop a very serious skin rash. If you notice an unexplained rash or blisters, fever, or itchy skin, stop using the medicine immediately and contact your healthcare provider.
     
  • Ketorolac nasal spray is an NSAID and should not be used with other NSAIDs. Using more than one NSAID at the same time can increase your risk for serious side effects (see Drug Interactions With Ketorolac Nasal Spray for more information, including a list of other NSAIDs). You can also ask your healthcare provider or pharmacist for a complete list of NSAIDs.
     
  • Ketorolac nasal spray can interact with a number of other medications (see Drug Interactions With Ketorolac Nasal Spray).
     
  • Ketorolac nasal spray is considered a pregnancy Category C medication in the beginning of pregnancy and a pregnancy Category D medication in the third trimester. Using this medication during pregnancy can potentially cause harm to your unborn child and complicate childbirth. Talk to your healthcare provider about the risks and benefits of using ketorolac nasal spray during pregnancy (see Sprix and Pregnancy).
     
  • Ketorolac nasal spray passes through breast milk in small amounts. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to using this medication (see Sprix and Breastfeeding).
     
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Ketorolac Nasal Spray Drug Information

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