Ketorolac is a potent NSAID and, like other NSAIDs, may cause serious side effects, such as gastrointestinal bleeding, which may result in hospitalization and even fatal outcome. Although serious GI tract ulcerations and bleeding can occur without warning symptoms, instruct patients to be alert for the signs and symptoms of ulcerations and bleeding, and to ask for medical advice when observing any indicative sign or symptom, including epigastric pain, dyspepsia, melena , and hematemesis . Instruct patients of the importance of this follow-up [see CONTRAINDICATIONS , WARNINGS AND PRECAUTIONS ].
The Specialist at Southampton General is correct; the IgG test only shows exposure and has no diagnostic value for food allergy or intolerance. So it’s a bit of a confusing test, as you end up avoiding numerous foods that are not problematic. Exposure need not necessarily be by consuming the food but can occur by being touched by someone who has handled the food or even via the respiratory tract. Many peanut IgE sensitised infants have never actually eaten peanuts but become sensitised by touch, creams and breathing in microscopic peanut particles.
Ketorolac can interact with other medications. Probenecid can increase the probability of having an adverse reaction or experiencing a side effect when taken with ketorolac. Pentoxifylline can increase the risk of bleeding. When aspirin is taken at the same time as ketorolac, the effectiveness is decreased. Problematic GI effects are additive and become more likely if potassium supplements, aspirin, other NSAIDS, corticosteroids , or alcohol is taken at the same time. The effectiveness of antihypertensives and diuretics can be lowered. The use of ketorolac can increase serum lithium levels to the point of toxicity. Toxicity to methotrexate is more likely if ketorolac is taken at the same time. The risk of bleeding increases with the concurrent medications clopidogrel , cefoperazone , valproic acid , cefotetan , eptifibatide , tirofiban , and copidine . Anticoagulants and thrombolytic medications also increase the likelihood of bleeding. Medications used to treat cancer can interact with ketorolac along with radiation therapy. The risk of toxicity to the kidneys increases when ketorolac is taken with cyclosporine .