Non-steroidal anti-inflammatory drugs (NSAIDs) play an important role in the pain management in various clinical conditions such as headaches, menstrual disorders, postoperative pain, spinal and soft tissue pain, rheumatoid arthritis (RA), osteoarthritis (OA), and ankylosing spondylitis (AS) by blocking cyclooxygenase (COX) enzymes that are needed to produce prostaglandin.^1,2

Ketorolac tromethamine (Toradol) is a NSAID available in Canada that is administered by either oral tablets or intramuscular injection,³ though this review will focus solely on oral administration. Oral Toradol has a Health Canada indication for short-term management (not to exceed 5 days for post-surgical patients or 7 days for patients with musculoskeletal pain) of moderate to moderately severe acute pain, including post-surgical pain, acute musculoskeletal trauma pain and post-partum uterine cramping pain.³ The recommended dose for oral administration is 10 mg every 4 to 6 hours, not exceeding 40 mg per day.³ Common side effects include rash, ringing in the ears, headaches, dizziness, drowsiness, abdominal pain, nausea, diarrhea, constipation, heartburn, and fluid retention.⁴ Toradol, like most NSAIDs, is commonly associated with gastrointestinal bleeding.⁴ In view of the concern regarding the potential safety risks and uncertainty of additional benefits compared with other NSAIDs, this report aims to review the clinical effectiveness of oral ketorolac for management of dental, non-dental, and non-cancer pain.