Sprix (ketorolac nasal) - Uses, Side Effects, and More

What are the most common side effects of Sprix?

The most common side effects of Sprix are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

• Discomfort or pain in the nose
• Watery or teary eyes
• Throat irritation
• Decreased urine (pee)
• Rash
• Slow heart rate
• Increased blood pressure (see below)
• Runny or stuffy nose

There may be other side effects of Sprix that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Sprix?

While less common, the most serious side effects of Sprix are described below, along with what to do if they happen.

Heart Attack and Stroke. Sprix can increase your risk of a heart attack or stroke that can lead to death. This risk is increased in people with existing heart disease and with longer use of Sprix and higher doses. Do not use Sprix if you have had a recent heart attack without talking to your healthcare provider. This could increase your risk of having another heart attack. Get emergency help if you have any of the following symptoms of a heart attack or stroke.

• Chest pain or pressure
• Fast or abnormal heartbeat
• Trouble breathing
• Pain in your back, jaw, throat, or arm
• Sweating, upset stomach, vomiting, or dizziness
• Sudden weakness on one side of your body
• Sudden and severe headache
• Slurred speech or trouble understanding speech

Bleeding. Sprix can increase your risk of bleeding, especially if you have a bleeding disorder or take other medicines that increase your risk of bleeding. Tell your healthcare provider right away if you notice signs of bleeding including easy bruising or bleeding.

Stomach Bleeding. Sprix can increase your risk of bleeding, ulcers, and tears (perforation) in your gut. The risk is higher if you have a history of stomach ulcers, bleeding problems, use higher doses of Sprix or use it for longer than directed, have poor health, are age 60 or older, have liver disease, smoke, drink alcohol, or take certain other medicines. Stop using Sprix and get emergency help right away if you have any of the following symptoms.

• Vomit blood
• Black or tarry poop
• Stomach pain that does not go away
• Upset stomach
• Feel faint

Severe Allergic Reactions. Sprix can cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop using the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain
• Dark-colored urine
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Severe Skin Reactions. Sprix can cause severe skin reactions called Exfoliative Dermatitis, Stevens-Johnson Syndrome (SJS), and Toxic Epidermal Necrolysis (TEN) which can lead to death if not treated. If you develop a rash, stop Sprix, and call your healthcare provider right away. Get emergency help right away if you have any of the following symptoms of a severe skin reaction.

• Painful red or purple skin that looks burned and peels off
• Flat red rash or blisters on your skin, mouth, nose, and genitals
• Red, painful, watery eyes
• Fever or general ill feeling
• Areas of thickened skin
• Sores that are crusted over

Increased Blood Pressure (Hypertension). Sprix may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your healthcare provider if your blood pressure increases while using this medicine. If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable but look out for any of the following symptoms of severely high blood pressure.

• Sudden severe headache
• Chest pain
• Dizziness or confusion
• Trouble breathing
• Nausea/vomiting
• Blurry or other changes to vision
• Anxiety
• Buzzing in the ears
• Nosebleed
• Feeling of skipped heart beats

Anemia. Sprix may cause anemia, which is a condition that causes low levels of red blood cells. Tell your healthcare provider if you have any of the following symptoms of anemia.

• Unusual weakness or tiredness
• Cold hands and feet
• Fast or abnormal heartbeat
• Pale or yellowish skin
• Dizziness, lightheadedness, or feeling like you are about to pass out

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using Sprix. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

• Nausea or vomiting
• Stomach or belly pain
• Fever
• Weakness or unusual tiredness
• Itching
• Loss of appetite
• Light-colored poop
• Dark-colored urine
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Heart Failure. Sprix may increase your risk for heart failure. Tell your healthcare provider right away if you have any of the following symptoms of heart failure.

• Shortness of breath or trouble breathing, especially while lying down
• Swelling in your feet, ankles, or legs (edema)
• Unusually fast weight gain
• Unusual tiredness

Kidney Damage. Kidney damage can happen when using Sprix. Stop using Sprix and call your healthcare provider right away if you have any of the following symptoms of kidney damage.

• Reduced need to pee
• Swelling in your feet, ankles, or legs (edema)
• Weakness or unusual tiredness
• Difficulty catching your breath or chest pain/pressure
• Confusion
• Nausea
• Seizures

High Potassium Level (Hyperkalemia). Sprix can cause a high potassium level (hyperkalemia), which can be serious and may lead to death. Your healthcare provider may check your potassium levels, especially if you take certain other medicines. Call your healthcare provider right away if you have any of the following symptoms of a high potassium level. 

• Muscle weakness or unusual tiredness
• Slow heartbeat or feeling of skipped heartbeats 
• Nausea or vomiting
• Trouble breathing
• Abnormal heart rhythm