Nonsteroidal anti-inflammatory drug

PCP: Mild to moderate pain

PCP: Severe pain in a multimodal approach 

Contraindications:

• Known hypersensitivity to ketorolac or other anti-inflammatories including aspirin
• Known or suspected renal dysfunction (GFR or Creatinine Clearance less than 30% or patient identifies as having kidney dysfunction)
• Concern for severe active bleeding (trauma, intracranial hemorrhage, GI bleeding)
• Pregnancy
• Use of anticoagulant (eg. apixaban, rivaroxaban, warfarin, edoxaban, dabigatran)

Caution:

• Severe volume depletion/dehydration
• Active cardiac emergency (myocardial infarction)
• Anti-inflammatory within the last 6-12 hours (eg. ibuprofen, celecoxib, naproxen)

Intramuscular:

• Onset:  20 minutes
• Duration: 6 hours

Intravenous:

• Onset: 10 minutes 
• Duration: 6 hours 

• GI upset (nausea, vomiting)

• Renal dysfunction

• Bleeding
• GI ulcer (low risk with single dose)