Ketorolac in the Media: Recent News, Safety Alerts, and What It Means for Patients

Ketorolac is a potent non‑steroidal anti‑inflammatory drug (NSAID) used for short‑term management of moderate to severe pain, typically administered as an IV, oral, or eye drop formulation. Because it blocks cyclooxygenase (COX) enzymes, it provides strong analgesia while sparing opioids, a feature that has kept it in the spotlight for both clinicians and the press.

What the Media Is Reporting

Across major outlets-from Australian health newsletters to U.S. business journals-the story line has been consistent: Ketorolac, once praised for its opioid‑sparing power, is now under renewed scrutiny. In July 2025, The Guardian ran a piece titled “Ketorolac Linked to Rising Kidney Injuries in Hospital Settings,” citing a multi‑center study of 12,000 postoperative patients that found a 2.3‑fold increase in acute kidney injury when the drug was used beyond 72hours.

Similarly, a Bloomberg Health report highlighted a surge in emergency‑room visits for gastrointestinal bleeding after over‑the‑counter (OTC) combinations of Ketorolac eye drops with topical NSAIDs. The data came from the National Hospital Ambulatory Medical Care Survey, which recorded 1,845 cases in the first six months of 2025-up 18% from the previous year.

In Australia, ABC News featured an interview with a Melbourne‑based nephrologist who warned that “the renal risk is real, especially in patients over 65 with pre‑existing chronic kidney disease.” The coverage sparked a social‑media debate, with many patients sharing personal anecdotes of severe stomach pain after a short course of Ketorolac following dental surgery.

Key Safety Concerns Highlighted in Recent Coverage

Three safety themes dominate the headlines:

• Renal impairment is a major concern because Ketorolac’s COX inhibition reduces prostaglandin‑mediated kidney blood flow.
• Gastrointestinal (GI) bleeding remains a risk, especially when combined with other NSAIDs or anticoagulants.
• Cardiovascular events have been flagged in a meta‑analysis linking high‑dose Ketorolac to increased heart‑attack incidence.

These alerts have prompted hospitals to tighten electronic medical‑record prompts, flagging patients with eGFR<60mL/min/1.73m² or a history of peptic ulcer disease before a Ketorolac order can be completed.

Regulatory and Guideline Updates

The U.S. Food and Drug Administration (FDA) released a safety communication in March 2025 that reiterates the 5‑day limit for any route of administration and advises against use in patients with:

• Severe renal dysfunction (creatinine clearance<30mL/min)
• Active gastrointestinal ulcer disease
• Concurrent use of anticoagulants such as warfarin or direct‑acting oral anticoagulants (DOACs)

The agency also requires manufacturers to include a bold warning label stating: “Risk of serious kidney injury and GI bleed-use only under close medical supervision.” In Europe, the EMA mirrored these recommendations in a 2025 guideline update, adding a contraindication for patients with “uncontrolled hypertension.”

Comparative Landscape: How Does Ketorolac Stack Up?

The table shows why Ketorolac continues to be the go‑to for acute, severe pain after surgery, yet its safety profile demands tighter patient selection.

Clinical Context: Where Ketorolac Shines

Three major indications dominate real‑world use, each with distinct media attention:

• Post‑operative pain: Orthopedic, abdominal, and ENT surgeries often include a short Ketorolac infusion to curb opioid demand. A 2024 randomized trial in the Journal of Clinical Anesthesia showed a 30% reduction in morphine consumption when Ketorolac was added to standard analgesia.
• Ophthalmic inflammation: The ophthalmic solution (0.5%) remains popular after cataract surgery. Recent Australian press reported a surge in off‑label eye‑drop use for allergic conjunctivitis, prompting a warning from the Therapeutic Goods Administration (TGA).
• Dental extraction pain: Dentists prescribe a single oral dose to manage third‑molar removal pain. Media stories from early 2025 highlighted cases of severe GI upset when patients combined this dose with over‑the‑counter ibuprofen.

In each setting, the drug’s rapid onset and strong analgesic effect are beneficial, but the risk window is narrow. The key is to balance effect with the individual’s comorbidities.

Practical Guidance for Clinicians

Based on the latest media reports and regulatory guidance, here’s a quick checklist you can integrate into your prescribing workflow:

1. Confirm indication: Use only for acute, severe pain expected to last ≤5days.
2. Screen renal function: eGFR≥60mL/min/1.73m² is generally safe; below that, avoid or use a reduced dose.
3. Assess GI risk: History of ulcer or bleeding, or concurrent NSAID/anticoagulant use → consider alternatives.
4. Set a stop date in the EMR: Automated alerts should fire at 48hours and again at 5days.
5. Educate patients: Explain the signs of kidney injury (reduced urine output, swelling) and GI bleed (black stools, severe abdominal pain).
6. Document: Record the justification for Ketorolac, especially if deviating from the 5‑day limit.

These steps address the most frequent concerns raised in the press and help avoid the pitfalls that have led to recent safety alerts.

Related Concepts and Next‑Step Topics

Understanding Ketorolac’s place in pain management opens the door to several adjacent subjects that readers often explore next:

• Opioid‑sparing strategies: multimodal analgesia, regional blocks, and non‑pharmacologic methods.
• NSAID pharmacology: COX‑1 vs COX‑2 inhibition, prostaglandin synthesis, and cardiovascular implications.
• Drug-drug interactions: How Ketorolac interacts with anticoagulants, ACE inhibitors, and diuretics.
• Post‑operative pain pathways: The role of inflammation, central sensitization, and neural blockade.
• Regulatory safety communications: How FDA and EMA alerts shape prescribing habits.

Delving into these topics can give clinicians a broader toolkit for managing pain while minimizing risk.

Frequently Asked Questions

What is the primary use of Ketorolac?

Ketorolac is most commonly prescribed for short‑term relief of moderate to severe pain, especially after surgery, dental procedures, or eye surgery. Its rapid onset makes it valuable when a strong analgesic is needed quickly.

Why has the media focused on kidney injury with Ketorolac?

Recent studies reported a higher incidence of acute kidney injury when Ketorolac was used beyond 72hours or in patients with pre‑existing renal compromise. The media has amplified these findings because they affect a large hospital population and prompt changes in prescribing protocols.

How does Ketorolac compare to ibuprofen for postoperative pain?

Ketorolac typically provides faster pain relief (10‑30minutes vs 30‑60minutes for ibuprofen) and stronger analgesia, which translates into less opioid consumption. However, its risk of GI bleeding and renal impairment is higher, especially with prolonged use.

Can I take Ketorolac if I’m on blood thinners?

Generally no. The FDA warns against combining Ketorolac with anticoagulants such as warfarin, apixaban, or rivaroxaban because the combination markedly raises the chance of serious gastrointestinal bleeding.

What alternatives exist for patients who can’t use Ketorolac?

Options include acetaminophen, selective COX‑2 inhibitors (e.g., celecoxib), regional anesthesia techniques, or short courses of low‑dose opioid patches for those who truly need stronger pain control. Each alternative carries its own risk‑benefit profile.