What is Ketorolac Nasal Spray: Uses, Dosage, Side Effects and More

Ketorolac nasal spray is a prescription pain medication that you spray directly into your nose for fast relief from moderate to severe pain. It's the same active ingredient found in ketorolac pills and injections, but delivered through your nasal passages where it can work quickly to reduce pain and inflammation.

This medication belongs to a group called NSAIDs (nonsteroidal anti-inflammatory drugs), which means it works by blocking the body's production of certain chemicals that cause pain and swelling. Think of it as a targeted way to get strong pain relief without having to take pills or receive injections.

What is Ketorolac Nasal Spray Used For?

Ketorolac nasal spray is specifically designed for short-term management of moderate to severe acute pain in adults. Your doctor might prescribe it when you need stronger pain relief than what over-the-counter medications can provide, but you want to avoid injections or have trouble keeping oral medications down.

Common situations where doctors prescribe this medication include post-surgical pain, severe headaches, kidney stone pain, or injury-related pain. It's particularly helpful when you need pain relief to start working quickly, as the nasal route allows the medication to enter your bloodstream faster than pills.

It's important to understand that this medication is only for short-term use, typically no more than 5 days. Your doctor will prescribe it when they need to provide you with effective pain control while minimizing the risks that come with longer-term NSAID use.

How Does Ketorolac Nasal Spray Work?

Ketorolac nasal spray is considered a strong pain medication that works by blocking enzymes called COX-1 and COX-2 in your body. These enzymes are responsible for making prostaglandins, which are chemicals that trigger pain, inflammation, and fever responses.

When you spray the medication into your nose, it gets absorbed through the nasal tissues and enters your bloodstream within 15-30 minutes. This makes it faster-acting than oral medications, which need to go through your digestive system first.

The medication is quite potent compared to other NSAIDs you might buy over-the-counter. It's roughly equivalent in strength to morphine for pain relief, but without the sedating effects or risk of dependency that come with opioid medications.

How Should I Take Ketorolac Nasal Spray?

Always follow your doctor's specific instructions for using ketorolac nasal spray, as the dosing is very individualized based on your pain level and medical history. The typical dose is one spray in each nostril every 6-8 hours as needed for pain, but never exceed the maximum daily amount your doctor prescribes.

Before using the spray, gently blow your nose to clear any mucus. Hold the bottle upright and insert the tip into one nostril while blocking the other with your finger. Press down firmly and quickly while breathing in gently through your nose. Repeat in the other nostril if prescribed.

You don't need to take this medication with food since it's absorbed through your nasal passages rather than your stomach. However, having some food in your stomach can help reduce the risk of stomach upset that sometimes occurs with NSAIDs.

Try to use the spray at the same times each day to maintain consistent pain relief. If you're using it for post-surgical pain, your doctor might recommend starting it before your pain becomes severe, as it's easier to prevent pain than to treat it once it's intense.

How Long Should I Take Ketorolac Nasal Spray For?

Ketorolac nasal spray is strictly a short-term medication, typically prescribed for no more than 5 days total. This includes any time you might have used ketorolac in other forms like pills or injections, as the limit applies to your total exposure to the medication.

The reason for this short duration is that longer use significantly increases your risk of serious side effects, particularly bleeding problems, kidney damage, and cardiovascular issues. Even though it's very effective for pain, the risks outweigh the benefits when used for extended periods.

Your doctor will work with you to transition to other pain management strategies before the 5-day limit is reached. This might include switching to different pain medications, using non-medication approaches like ice or heat therapy, or addressing the underlying cause of your pain.

What Are the Side Effects of Ketorolac Nasal Spray?

Like all medications, ketorolac nasal spray can cause side effects, though not everyone experiences them. The most common side effects are usually mild and relate to the nasal route of administration or the medication's effects on your body.

Here are the side effects you might notice, starting with the most common ones:

• Nasal irritation, burning, or stinging sensation
• Runny or stuffy nose
• Sneezing or throat irritation
• Headache or dizziness
• Nausea or stomach discomfort
• Drowsiness or feeling tired

These common side effects are usually temporary and tend to improve as your body adjusts to the medication. The nasal irritation often lessens after the first few uses.

However, there are some serious side effects that require immediate medical attention, though they're less common:

• Signs of bleeding like black, tarry stools or vomiting blood
• Severe stomach pain or persistent nausea
• Chest pain or difficulty breathing
• Swelling in your face, hands, or feet
• Sudden severe headache or vision changes
• Signs of kidney problems like changes in urination

If you experience any of these serious symptoms, contact your healthcare provider immediately or seek emergency medical care.

Some people may also experience rare but serious allergic reactions, including severe skin rashes, difficulty breathing, or swelling of the face and throat. These reactions require immediate emergency treatment.

Who Should Not Take Ketorolac Nasal Spray?

Ketorolac nasal spray isn't safe for everyone, and there are several important situations where your doctor won't prescribe it or will use it with extreme caution. Your safety is the top priority, so it's crucial to discuss your complete medical history with your healthcare provider.

You should not use ketorolac nasal spray if you have any of these conditions:

• History of allergic reactions to ketorolac, aspirin, or other NSAIDs
• Active bleeding or bleeding disorders
• Severe kidney disease or kidney failure
• Severe heart failure or recent heart attack
• Active stomach ulcers or history of bleeding ulcers
• Pregnancy, especially in the third trimester
• Breastfeeding (as the medication passes into breast milk)

Your doctor will also be very cautious about prescribing this medication if you have certain risk factors that make complications more likely.

Conditions that require special consideration include:

• Mild to moderate kidney or liver problems
• High blood pressure or heart disease
• History of stomach problems or previous ulcers
• Asthma or other breathing problems
• Blood clotting disorders
• Age over 65 (higher risk of side effects)
• Taking blood thinners or certain other medications

If you have any of these conditions, your doctor might choose a different pain medication or monitor you more closely if ketorolac is still the best option for your situation.

Ketorolac Nasal Spray Brand Names

The most commonly available brand name for ketorolac nasal spray is Sprix, which is manufactured by Egalet Corporation. This is the primary brand you'll likely encounter when your doctor prescribes ketorolac nasal spray.

Sprix comes in a small, easy-to-use bottle that delivers a precise dose with each spray. The medication concentration is standardized, so you can expect consistent dosing whether you're using your first bottle or refilling your prescription.

Generic versions of ketorolac nasal spray may also be available, which contain the same active ingredient but may cost less than the brand-name version. Your pharmacist can help you understand if a generic option is available and appropriate for your needs.

Ketorolac Nasal Spray Alternatives

If ketorolac nasal spray isn't right for you, your doctor has several other options to help manage your pain effectively. The choice depends on your specific situation, medical history, and the type of pain you're experiencing.

Other NSAID options include oral medications like ibuprofen (Advil, Motrin) or naproxen (Aleve) for milder pain, or stronger prescription NSAIDs like diclofenac or celecoxib for more severe pain. These work similarly to ketorolac but may have different side effect profiles.

For severe pain, your doctor might consider short-term opioid medications like oxycodone or tramadol, especially if NSAIDs aren't suitable due to your medical history. These medications work differently by affecting pain signals in your brain and spinal cord.

Non-medication approaches can also be very effective and might include physical therapy, ice or heat therapy, massage, or techniques like meditation and breathing exercises. Many people find that combining these approaches with medication provides the best pain relief.

Is Ketorolac Nasal Spray Better Than Ibuprofen?

Ketorolac nasal spray is significantly stronger than ibuprofen and works faster, but that doesn't necessarily make it "better" for everyone. The right choice depends on your pain severity, medical history, and how long you need pain relief.

Ketorolac is much more potent than ibuprofen and can handle moderate to severe pain that ibuprofen might not touch. It also starts working faster because it's absorbed through your nasal passages rather than going through your digestive system.

However, ibuprofen is much safer for longer-term use and has fewer serious side effects. You can take ibuprofen for weeks or even months if needed, while ketorolac is strictly limited to 5 days maximum.

Your doctor will choose ketorolac when you need stronger, faster pain relief for a short period, and ibuprofen when you need milder but longer-lasting pain management. Both are excellent medications when used appropriately for the right situations.