When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to ketorolac, ethylenediamine tetraacetic acid (EDTA), aspirin, or other similar medicines.

How to Use This Medicine:
Spray

• Your doctor will tell you how much medicine to use. Do not use more than directed. Use each bottle for one day only.
• This medicine is for use only in the nose. Do not get any of it in your eyes or on your skin. If it does get on these areas, rinse it off right away. Do not breathe in this medicine while spraying.
• The first time you use each bottle, you will need to prime the pump. To do this, pump the bottle 5 times until some of the medicine sprays out. The bottle is now ready to use.
• Before using the medicine, gently blow your nose to clear the nostrils.
• After using the nasal spray, wipe the tip of the bottle with a clean tissue and put the cap back on.
• This medicine is not for long-term use. Do not use it for more than 5 days in a row.
• Drink extra fluids so you will urinate more often and help prevent kidney problems.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Keep the unopened bottle in the refrigerator. Once opened, store the bottle at room temperature, away from heat and direct sunlight. Throw away any unused medicine 24 hours after you opened the bottle and used your first dose. Do this even if some medicine remains in the bottle.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with pentoxifylline or probenecid.
• Do not use any other forms of ketorolac (such as injection or tablets) or other NSAIDs, unless your doctor says it is okay. Some other NSAIDs include aspirin, diclofenac, diflunisal, ibuprofen, naproxen, or salsalate.
• Some foods and medicines can affect how ketorolac works. Tell your doctor if you are using any of the following:
  
  • Alprazolam, carbamazepine, digoxin, fluoxetine, lithium, methotrexate, pemetrexed, phenytoin, thiothixene
  • Blood pressure medicine
  • Blood thinner (including heparin, warfarin)
  • Diuretic (water pill)
  • Medicine to treat depression
  • Steroid medicine

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding. Do not use this medicine during the later part of a pregnancy, unless your doctor tells you to.
• Tell your doctor if you have kidney disease, liver disease, asthma, anemia, blood clotting problems, heart failure, high blood pressure, heart or blood vessel problems, a recent heart attack, or a history of stomach ulcers or bleeding problems. Tell your doctor if you drink alcohol.
• This medicine may cause the following problems:
  
  • Higher risk of blood clots, heart failure, heart attack, or stroke
  • Bleeding in your stomach or intestines
  • Liver problems
  • High blood pressure
  • Kidney problems and high potassium levels
  • Serious skin reactions
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Change in how much or how often you urinate
• Chest pain that may spread to your arms, jaw, back, or neck, trouble breathing, unusual sweating, fainting
• Dark urine or pale stools, nausea, vomiting, loss of appetite, yellow skin or eyes
• Numbness or weakness in your arm or leg, or on one side of your body, pain in your lower leg, sudden or severe headache, or problems with vision, speech, or walking
• Rapid weight gain, swelling in your hands, ankles, or feet
• Red or black stools, severe stomach pain, vomiting blood or material that looks like coffee grounds

If you notice these less serious side effects, talk with your doctor:

• Constipation, diarrhea, heartburn, stomach pain, or upset stomach
• Dizziness
• Nasal discomfort or irritation

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088