Ketorolac Trometamol

Non-steroidal anti-inflammatory drug (NSAID) structurally related to indometacin, with less anti-inflammatory effect than other NSAIDs. Oral or intravenous administration every 6 hours.

It is excreted in breast milk in clinically insignificant amounts ^{(Wischnik 1989)}. No problems have been observed in infants whose mothers received ketorolac during caesarean section ^{(Hadley 2019)}. Administration of a dose of ketorolac during or immediately after caesarean section did not affect breastfeeding rates ^{(Yurashevich 2020, Hadley 2019)}.

Pain control with sufficient doses of ketorolac improves exclusive breastfeeding rates. ^{(Teigen 2020)}

Authorized use in neonates from 21 days old. ^{(Martin 2017, Cohen 2011, Aldrink 2011, Papacci 2004)}

Various medical societies and expert consensus consider the use of this medication safe during breastfeeding ^{(Wagner 2018, Reece 2017, Worthington 2013, Østensen 2007, Lee 1993)}, although most recommend limited dosage and duration and oral administration. Since the possibility of harmful effects on the blood and kidney among treated patients is controversial (not through breast milk) high dosing would better be avoided within 21 days post delivery. ^{(Reece 2017, Worthington 2013)}

Keratolac eye drops are very safe because a low content of drug.

American Academy of Pediatrics: medication usually compatible with breastfeeding.^{(AAP 2001)}