Ketorolac Nasal Spray

pronounced as (kee toe role' ak)

Brand Name(s): Sprix®

Why is this medicine prescribed?

Ketorolac nasal spray is used for the short-term relief of moderate to moderately severe pain. Ketorolac is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

Are there other uses for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Nasal ketorolac comes as a liquid to spray in the nose. It is usually used once every 6 to 8 hours as needed to control pain for up to 5 days. Use ketorolac nasal spray exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Ketorolac nasal spray comes in bottles that each contain a one-day supply of medication. Do not use any single bottle of ketorolac nasal spray for more than one day. Dispose of the bottle within 24 hours of using the first dose, even if the bottle still contains some medication. You will receive enough bottles of medication so that you have a new bottle to use for each day of treatment.

Before you use ketorolac nasal spray for the first time, read the written instructions that come with the medication. Be sure that you understand how to prepare the bottle before the first use and how to use the spray. Ask your doctor or pharmacist if you have any questions about how to use this medication.

Ketorolac nasal spray is only for use in the nose. Be careful not to get the medication in your eyes. If you do get ketorolac nasal spray in your eye, wash out the eye with water or sterile saline solution and call your doctor if irritation lasts longer than an hour.

You may have an uncomfortable feeling in your throat after you use ketorolac nasal spray. If this happens, drink a sip of water.

What special precautions should I follow?

Before using ketorolac nasal spray,

  • Tell your doctor if you are allergic to ketorolac, aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn), any other medications, or ethylendiamine tetraacetic acid (EDTA; an ingredient found in some foods and medications), or any of the other ingredients in ketorolac nasal spray. Ask your pharmacist for a list of the ingredients.
  • tell your doctor if you are taking pentoxifylline (Pentoxil, Trental) or probenecid. Your doctor will probably tell you not to use ketorolac nasal spray if you are taking these medications.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: alprazolam (Niravam, Xanax); carbamazepine (Epitol, Tegretol); lithium (Eskalith, Lithobid); methotrexate (Rheumatrex, Trexall); phenytoin (Dilantin, Phenytek);or thiothixene (Navane). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you are pregnant, plan to become pregnant; or are breast-feeding. Ketorolac nasal spray may harm the fetus and cause problems with delivery if it is used around 20 weeks or later during pregnancy. Do not use ketorolac nasal spray around or after 20 weeks of pregnancy, unless you are told to do so by your doctor. If you become pregnant while using ketorolac nasal spray, call your doctor.
  • tell your doctor if you have or have ever had the conditions listed in the IMPORTANT WARNING section or asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose), inflammatory bowel disease such as Crohn's disease (a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever) or ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum).
  • If you are having surgery, including dental surgery, tell the doctor or dentist that you are using ketorolac nasal spray.

What special dietary instructions should I follow?

Make sure you drink plenty of fluids while using ketorolac nasal spray.

What should I do if I forget to take a dose?

This medication is usually used as needed. If your doctor has told you to use ketorolac nasal spray regularly, use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

What should I do in case of overdose?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

  • stomach pain
  • nausea
  • vomiting
  • decreased urination
  • bloody, black, or tarry stools
  • vomit that is bloody or looks like coffee grounds
  • drowsiness
  • slowed breathing
  • coma (loss of consciousness for a period of time)

What side effects can this medicine cause?

Ketorolac nasal spray may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • pain, discomfort, or irritation in your nose
  • increased tears
  • irritation in your throat

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

  • rash
  • hives
  • itching
  • difficulty breathing or swallowing
  • hoarseness
  • extreme tiredness
  • lack of energy
  • loss of appetite
  • pain in the upper right part of the stomach
  • yellowing of the eyes or skin
  • flu-like symptoms
  • fever
  • blistering or peeling skin
  • slow heartbeat

Ketorolac nasal spray may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( ) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from direct sunlight, excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( ) for more information if you do not have access to a take-back program.

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else use your medication. This prescription is not refillable. If you continue to have pain after you finish using ketorolac nasal spray, call your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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