Ketorolac tablet - maximum daily dose

• Maximum dose: 40 mg per day (oral) - Firestein & Kelley's Textbook of Rheumatology, 2-Volume Set
• This is typically given as 10 mg every 4-6 hours as needed, not exceeding 40 mg/day.
• Oral ketorolac is only used as continuation therapy after parenteral (IM/IV) dosing, never as initial therapy for acute pain.

• Ketorolac (in any form - oral, IM, or IV) should not be used for more than 5 days total (combined duration across all routes), due to risk of GI bleeding, renal impairment, and other NSAID-related toxicity - Firestein & Kelley's Textbook of Rheumatology, p. (block13, line ~8720-8725).

• IM: 60 mg loading dose, then 15-30 mg every 6 hours
• IV: 30 mg loading dose, then 15-30 mg every 6 hours
• Combined maximum (parenteral): up to 120 mg/day in adults - Morgan and Mikhail's Clinical Anesthesiology, 7e

• Elderly patients (>65 years), renally impaired patients, or those <50 kg: dose should be reduced by roughly 50%, and the maximum oral dose is often capped lower (commonly cited as 40 mg/day still applies, but some protocols reduce to lower doses in these groups) due to slower clearance.
• Contraindicated/relatively contraindicated in patients with active peptic ulcer disease, significant renal impairment, and asthmatics with NSAID-sensitivity (risk of bronchoconstriction).