Anaphylaxis as a Rare Side Effect of Ketorolac; a Case Report

Non-steroidal anti-inflammatory drugs (NSAIDs) constitute a broad spectrum of cyclooxygenase (COX) inhibitors suppressing prostaglandin synthesis. NSAIDs are used for treating various conditions such as pain, rheumatoid arthritis, osteoarthritis, and musculoskeletal disorders (1). Ketorolac is an NSAID, which is used to alleviate renal colic due to its anti-contractile effects on the urethra. Considering the pain pathogenesis in renal colic, ketorolac is one of the best pain-relieving drugs in these patients (2). In intravenous form, this drug reaches its serum peak level within 1 to 3 minutes. Ketorolac is metabolized in the liver and excreted through the kidneys (2). Although ketorolac has an excellent safety profile, allergic reactions and anaphylaxis may occur following its administration. Even though these reactions, either acute or delayed, are uncommon and rare, they can be fatal (3). A number of studies have reported anaphylactic reactions after ketorolac administration. However, the incidence of these reactions is not predictable (4-6). Here, we present a case of anaphylaxis in a male patient admitted to the emergency department of Vali-e-Asr Hospital, Arak, Iran, following the injection of 30 mg ketorolac.