Ketorolac nasal spray: uses, dosing, and side effects
Last updated September 7, 2026.
**Ketorolac nasal spray is a prescription pain medicine in the nonsteroidal anti-inflammatory drug (NSAID) class.** It reduces substances that cause pain and inflammation. Never use ketorolac for more than 5 total days, counting injections, tablets, and nasal spray together, because longer treatment increases the risk of serious bleeding and kidney injury.
What does it treat?
You may receive ketorolac nasal spray, sold as Sprix, for moderate to moderately severe acute pain, such as pain after surgery that requires strong pain relief. Your clinician decides whether your pain needs this level of treatment and whether your bleeding and kidney risks allow it. It is intended for adults, not for mild aches or ongoing arthritis pain.
How do you take it?
Each spray contains 15.75 mg. If you are younger than 65, weigh at least 110 pounds (50 kg), and have normal kidney function, the labeled dose is one spray in each nostril, totaling 31.5 mg, every 6 to 8 hours, with a maximum of 126 mg in 24 hours. If you are 65 or older, weigh less than 110 pounds, or have kidney impairment, the labeled dose is one spray in only one nostril every 6 to 8 hours, with a maximum of 63 mg in 24 hours; advanced kidney disease rules out use. Follow the priming instructions, aim away from the center of your nose, and do not inhale the spray. Discard each opened bottle within 24 hours of first use. You do not need food with a dose; maintain adequate fluid intake. If prescribed regularly, take a missed dose when remembered unless the next dose is almost due; then skip it and never double up. Stop by day 5 and call your clinician if pain persists, or stop sooner and call for stomach pain, a rash, or reduced urination.
Side effects to know
- Common: You may notice brief nasal burning or discomfort, a runny nose, watery eyes, or throat irritation.
- Serious: Stop using the spray and get prompt medical help for reduced urination, new swelling, yellow skin or eyes, or a rash, especially with fever or blisters. Chest pain, stroke symptoms, vomiting blood, black stools, or facial or throat swelling require emergency evaluation.
Who should not take it?
Do not use it if you have an allergy to ketorolac or its ingredients, an aspirin or NSAID allergic reaction, an active stomach ulcer, recent digestive bleeding, advanced kidney disease, severe dehydration, or a high bleeding risk. It must not be used around heart bypass surgery, to prevent pain before major surgery, or during labor and delivery. Do not combine it with other ketorolac forms, aspirin, ibuprofen, naproxen, probenecid, or pentoxifylline. Before starting, discuss previous ulcers, asthma, heart or liver disease, high blood pressure, and all medicines, especially blood thinners, steroids, antidepressants, blood pressure medicines, diuretics, lithium, and methotrexate. Avoid alcohol because it increases stomach bleeding risk. Discuss pregnancy or plans to conceive first: use from about 20 to 30 weeks requires specific clinician direction, and avoid use at about 30 weeks or later. Ketorolac enters breast milk; your clinician should weigh your treatment need and breastfeeding benefits against possible infant risks.
When is it an emergency?
For an extra dose or suspected overdose, call Poison Control at 1-800-222-1222 immediately, even without symptoms. Overdose can cause stomach pain, vomiting, unusual drowsiness, digestive bleeding, or kidney problems. Call 911 for collapse, breathing trouble, face or throat swelling, chest pain, sudden weakness on one side, or slurred speech. Vomiting blood, black tarry stools, or severe abdominal pain need emergency care now; call 911 if you also feel faint or cannot travel safely.
What a Pymander AI doctor consult looks like
Illustrative example, not a real member's messages.
Common questions
What is the maximum dose, and do injections count toward the limit?
The usual adult maximum is 126 mg in 24 hours, given as four doses of one spray in each nostril. Your maximum is 63 mg in 24 hours if you are 65 or older, weigh under 110 pounds, or have kidney impairment. Every dose must follow your prescribed interval of 6 to 8 hours. Injections and tablets count toward the same 5 total treatment days, and you must not use them together with the spray.
Can I drink alcohol while using it?
Avoid alcohol during treatment. Alcohol increases your risk of stomach or intestinal bleeding with ketorolac. Using a nasal spray does not remove this risk.
Can I use it during pregnancy or breastfeeding?
Tell your clinician before using it if you are pregnant, trying to conceive, or breastfeeding. From about 20 to 30 weeks of pregnancy, use requires specific medical direction because it can affect your baby's kidneys and reduce amniotic fluid. Avoid it at about 30 weeks or later because it can also close an important fetal blood vessel too early. Do not use it during labor or delivery. Ketorolac passes into breast milk, so you and your clinician should review the benefits and risks before treatment.
Do I need food, and should I sniff the spray?
You do not need to time your dose with food. Continue your usual diet and drink enough fluid to avoid dehydration unless your clinician has restricted fluids. Follow the bottle's priming instructions and spray with your head slightly tilted forward. Breathe through your mouth while spraying; do not sniff it into your lungs.
What should I do if I use too much?
Call Poison Control at 1-800-222-1222 immediately and report the spray strength, number of sprays, and timing. Do not wait for symptoms or take another dose before receiving advice. Overdose symptoms include stomach pain, vomiting, unusual drowsiness, bloody vomit, or reduced urination. Call 911 for collapse or breathing trouble.
Can I combine it with ibuprofen, aspirin, or a blood thinner?
Do not combine it with ibuprofen, naproxen, aspirin, or another form of ketorolac. If you take prescribed aspirin or a blood thinner, contact your prescriber before starting the spray rather than stopping your regular medicine yourself. These combinations increase bleeding risk. Probenecid and pentoxifylline must not be taken with ketorolac, and your pharmacist should review your full medication list.