The Medical Letter on Drugs and Therapeutics
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Off-Label Use of Ketorolac for Athletic Injuries

Recent reports indicate that intramuscular (IM) injection of the nonsteroidal anti-inflammatory drug (NSAID) ketorolac (Toradol, and others), sometimes directly into injured muscles, has become a common practice in US locker rooms.1

KETOROLAC — A non-selective NSAID available for oral, intranasal, IM or IV administration, ketorolac is approved by the FDA for short-term (≤5 days) management of moderately severe acute pain that requires analgesia at the opioid level, usually in a postoperative setting. It has shown to be as effective as morphine or meperidine (Demerol, and others); 30 mg of ketorolac IM, the usual analgesic dose for continued use, is considered comparable to 12 mg of morphine, but with a longer duration of action (about 5-6 hours).2 Single-dose injections may be with 60 mg. The maximum daily dosage for adults ... more      

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