Ketorolac is a nonsteroidal anti inflammatory drug (NSAID).

Ketorolac nasal (for the nose) is used short-term (5 days or less) to treat moderate to severe pain.

Ketorolac may also be used for purposes not listed in this medication guide.

Ketorolac can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ketorolac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults.

You should not use this medicine if you are allergic to ketorolac, or if you have:

• severe kidney disease;
• a bleeding or blood clotting disorder;
• a closed head injury or bleeding in your brain;
• a stomach ulcer, perforation, or a history of stomach or intestinal bleeding; or
• if you are breast-feeding a baby; or
• if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

Pentoxifylline or probenecid can interact with ketorolac and should not be used at the same time.

Do not use ketorolac nasal if you are already taking aspirin or other NSAIDs, or using other forms of ketorolac (such as injections or pills you take by mouth).

Tell your doctor if you have ever had:

• heart disease, high blood pressure;
• a heart attack, stroke, or blood clot;
• stomach ulcers or bleeding;
• ulcerative colitis or Crohn's disease;
• asthma;
• liver or kidney disease;
• fluid retention; or
• if you smoke.

If you are pregnant, you should not use ketorolac nasal unless your doctor tells you to. Using an NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy.

Ketorolac may affect ovulation, which could temporarily affect fertility (your ability to have children).

Tell your doctor if you are breastfeeding.

Ketorolac nasal is not approved for use by anyone younger than 2 years old.

Use Sprix (Nasal) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, leg swelling, feeling short of breath.

Stop using ketorolac and call your doctor at once if you have:

• any skin rash, no matter how mild;
• high blood pressure--severe headache, blurred vision, pounding in your neck or ears;
• heart problems--swelling, rapid weight gain, feeling short of breath;
• kidney problems--little or no urination, swelling in your feet or ankles, feeling tired or short of breath;
• liver problems--nausea, upper stomach pain, itching, tiredness, flu-like symptoms, dark urine, jaundice (yellowing of the skin or eyes);
• low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or
• signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.

Common side effects may include:

• heartburn, stomach pain, gas, nausea, vomiting;
• diarrhea, constipation;
• slow heartbeats;
• decreased urination;
• abnormal liver function tests;
• increased blood pressure;
• pain or irritation in your nose;
• runny nose;
• watery eyes;
• throat irritation; or
• rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Avoid getting this medication in your eyes. If this does happen, rinse with water or saline solution. Call your doctor if you have eye irritation for longer than 1 hour.

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid taking aspirin or other NSAIDs while you are using ketorolac nasal.

Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to ketorolac (such as aspirin, ibuprofen, ketoprofen, or naproxen).