(kee-toh-ROH-lack tro-METH-ah-meen)
Toradol
NSAID
pH 6.9 to 7.9
Usual dose
Adults under 65 years:
30 mg. May repeat every 6 hours. Maximum dose is 120 mg/24 hr. Do not increase the dose or frequency for breakthrough pain. Consider alternating with low doses of opioids (e.g., morphine or meperidine). Ketorolac oral may be used only as continuation therapy to parenteral dosing. Maximum oral dose is 40 mg/24 hr. Do not administer for longer than 5 days (IV/IM alone or combined use with oral).
Adults over 65 years, patients with impaired renal function, and/or patients under 50 kg (110 lb):
15 mg. May repeat every 6 hours. Maximum dose is 60 mg in 24 hours. Note all restrictions for adults under 65 years outlined above.
Pediatric dose
See Maternal/Child.
Pediatric patients 2 to 16 years of age:
One dose of 0.5 mg/kg up to a maximum dose of 15 mg. 0.5 mg/kg IV every 6 hours has been administered in a limited number of patients (unlabeled).
Short-term postoperative pain management (unlabeled):
1 mg/kg alone or as an adjunct.
Dose adjustments
Required for patients under 50 kg (110 lb), patients over 65 years of age, and patients with reduced renal function (moderately elevated SCr); see Usual Dose. Further dose reductions may be required with high-dose salicylates; see Drug/Lab Interactions.
Dilution
Confirm IV use. Some 2-mL tubex syringes are for IM use only. May be given undiluted through Y-tube or three-way stopcock of infusion set. Administration through a free-flowing IV is preferred.
Storage:
Store at CRT; protect from light.
Compatibility (underline indicates conflicting compatibility information)
Consider any drug NOT listed as compatible to be INCOMPATIBLE until consulting a pharmacist; specific conditions may apply.
May form a precipitate if admixed with drugs with a low pH (e.g., meperidine [Demerol], morphine, promethazine [Phenergan]).
One source suggests the following compatibilities:
Solution:
D5W, NS, D5NS, LR, R.
Y-site:
Acetaminophen (Ofirmev), cisatracurium (Nimbex), dexmedetomidine (Precedex), fentanyl, hetastarch in electrolytes (Hextend), hydromorphone (Dilaudid), methadone (Dolophine), morphine, remifentanil (Ultiva).
Rate of administration
A single dose over a minimum of 15 seconds; evenly distributed over 1 to 2 minutes is preferred.
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