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. 2023 Aug 9;85(10):4662-4666.
doi: 10.1097/MS9.0000000000001156. eCollection 2023 Oct.

Ketorolac-induced anaphylaxis following oral administration: a case series

Tek N Yogi  1 , Amrit Bhusal  2 , Rijan Kafle  1 , Sujal Labh  1 , Sagar Pokhrel  1
Affiliations

Ketorolac-induced anaphylaxis following oral administration: a case series

Tek N Yogi et al. Ann Med Surg (Lond). .

Abstract

Background: Ketorolac is a commonly used non-steroidal anti-inflammatory drug for reducing pain and inflammation. Anaphylaxis is a medical emergency that occurs after exposure to an allergen, with a varied clinical presentation requiring prompt and appropriate measures to prevent or manage it. Although uncommon, ketorolac can cause anaphylaxis requiring immediate medical care. The authors present two cases of anaphylaxis in females induced after oral intake of ketorolac with successful outcomes.

Case presentations: The cases involve two adult women who experienced an allergic reaction to ketorolac. The first woman, aged 36, and the second woman, aged 26, on her second postpartum day, both developed similar types of symptoms like periorbital swelling, itching, and difficulty breathing after taking oral ketorolac. The second woman had a history of allergic rashes. They received immediate treatment with epinephrine, oxygen therapy, intravenous fluids, and other medications. They showed a rapid improvement and were discharged after observation.

Clinical discussion: Anaphylactic reactions to ketorolac, a commonly used pain management drug, have been reported. Symptoms include swelling, difficulty breathing, and hypotension. Treatment involves medications like epinephrine, hydrocortisone, and pheniramine. A detailed medical history, laboratory investigations, appropriate medication, oxygen therapy, and follow-up care are important in managing anaphylactic reactions, which can be life-threatening.

Conclusion: Although rare, ketorolac can cause anaphylactic reactions in patients with or without a history of drug allergy. Immediate recognition and management are essential, along with a detailed medical history and follow-up care.

Keywords: anaphylaxis; case series; cyclooxygenase; drug allergy; epinephrine; ketorolac.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Periorbital swelling.
Figure 2
Figure 2
Rashes over the left arm after intense itching.
Figure 3
Figure 3
Gross swelling of the periorbital regions and lips.
See this image and copyright information in PMC

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