Sprix ketorolac tromethamine

Wheaton cosmetic dentist Bryan Bauer

31.5mg every 6-8 hours (1 spray of 15.75mg each nostril) 126mg max daily dose

if  >64, renally impaired, <110lbs then 15.75mg every 6-8 hours  63mg max daily dose

  1. Lacks side effects of opioids and no risk of abuse
  2. Only non-opioid alternative for treatment of moderate to severe pain

Common side effects

  • Nasal discomfort
  • Nasal stinging
  • Increased lacrimation
  • Throat irritation


  • Can not use with other ketorolac formulations, not over 5 days of usage
  • No allergy to aspirin, NSAID, ketorolac, EDTA
  • Anti-epileptic drugs (phenytoin, carbamazepine) may cuase seizure
  • Cyclosporine
  • Lithium BIG NO-NO
  • Methotrexate BIG NO-NO
  • Psychoactive drugs cause hallucinations Prozac, Navane, Niravam
  • Caution with serious liver disease
  • Only use with caution in first 30 weeks pregnancy NO-NO after 30
  • All NSAIDs can cause serious skin reactions, discontinue immediately if skin reaction

GI Risk

  • Contraindicated in those with peptic ulcers
  • Recent GI bleed or perf
  • History of either of the above
  • Increase risk GI bleeding if on warfarin (anti-coagulants), or SSRI
  • Those taking other NSAIDs

Bleeding Risk

  • CV bleeding or high risk CV incident
  • Hemorrhagic diathesis
  • High risk for bleeding for any reason
  • Those taking Aspirin

Renal Risk

  • Contraindicated in those with advanced renal impairment
  • Those taking ACE inhibitors/angiotensin II receptor antagonists