According to the drug SPC, ketorolac is contraindicated in moderate to severe renal impairment
(serum creatinin >442 μmol/l) and in patients at risk of renal failure due to volume
depletion or dehydration. As it is a potent prostaglandin inhibitor, ketorolac should be used
cautiously in patients with a history of renal disease or otherwise impaired renal function.
Ketorolac-related renal toxicity has been reported in conditions associated with hypovolemia
and/or renal blood flow where renal prostaglandins have an important role in maintaining kidney
perfusion. In these conditions, the use of ketorolac can lead to a decrease in renal prostaglandins,
increasing the risk of precipitating renal failure [48, 49].