My Experience Using Ketorolac to Abort Migraine Attacks

By Amanda Osowski

3 min read

In my nearly thirty years of living with migraines, I've struggled time and time again to find a medication that effectively stopped a migraine once it had already started.

What medications have I tried in the past?

For a few years of my adult life, Fioricet was able to work as an abortive medication for my migraines, although I eventually fell into the trap where using it too much caused rebound migraines and then I was trapped in a cycle of no good.

Shortly after that, there was a period of time in which once I was "too far in" to a migraine, I had no choice but to go to the emergency room, or later, to the infusion suite at my neurologists office for an IV cocktail of medication to stop my migraine in its tracks. While not every migraine cocktail is the same, most contain some sort of triptan (an anti inflammatory medication like Imitrex), an NSAID (like Ketorolac), a steroid (like prednisone or dexamethasone) and simultaneous IV fluids for hydration as well as an anti-emetic medication to reduce nausea (like compazine, reglan or zofran).

What preventive treatments am I using?

Once I got on a migraine preventative (Qulipta) and began using Botox every three months in order to help stave off my migraines, I've experienced fewer migraines, and when I do get them, they tend to be less severe and crippling.

Although, that's not to say it doesn't happen.

How do I treat my worst migraine attacks? Over the last two years, I'd say about once or twice a month I get a migraine that needs extra forces. Fioricet is still my first line medication for migraine abortion, but now I know to only take it if the severity of the migraine is mild to moderate. Once I'm closer to severe, I'm beyond how it can help, and it'll only cause future problems.What has worked almost every time for me is intramuscular injections of ketoralac (Toradol).It took a few months of my doctor modifying the dose and protocol, but now I find this the most valuable tool in my belt, proverbially speaking.I currently use 2 vials of the 30mg/ml solution (so a total of 60 mg of medication in 2ml of liquid) as an IM injection. For better or worse, I'm someone who has given myself a lot of injections (subcutaneous and intramuscular) so this doesn't make me queasy or feel like a struggle, but I will say when my migraine is debilitating I do ask my husband to prepare and inject the medication for me.What are my injection steps?Here are the steps I go through for anyone who is considering asking their doctor about this medication and wants to learn more:I take out all of my supplies - two vials of medication, a syringe and a needle, alcohol swabs, gauze and a bandaid.I pop the tops off the two vials and sanitize them with alcohol swabs.I twist the needle on the syringe, and then I draw back about 1ml of air. I puncture the first vial, flip it upside down, push in the air, and then draw back the 1ml of solution. I then do the same thing with the second vial, collecting all 2ml in my syringe.Next, I sanitize my skin where I'm going to do the injection. If I'm injecting myself, I do it in my upper thigh. If someone else is injecting into me, I have them do it in my upper outer butt cheek.Insert the needle all the way into the skin, draw back the syringe a tiny bit to ensure no blood comes out into the needle, and then slowly press in the medication. I've found with this medication specifically, it stings if I push it too fast.Do the injections always work?For me, generally it takes 1-2 hours for the medication to take full effect, and most times I try to go back to sleep during this time. When I wake up, I usually feel a lot better, or at least functional enough to hydrate and get some caffeine, reducing the migraine a bit more.In the cases where one dose doesn't work, or doesn't last long enough, I can do another injection 6-8 hours later (but not more than 2 total in 24 hours).Although it's definitely some extra work to carry injectable medication and supplies with me regularly, I have found this to easily be the most effective migraine abortive I've ever tried.If you've used Ketorolac injections, I'd love to hear your experiences below!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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Amanda Workman Moderator & Contributor
<inline-mention username="Amanda Osowski" user-id="3666630"/> I am so glad that you found something that helps you, even if it takes a bit more work than just a pill. At one point, I was prescribed toradol injections for my migraines. It definitely helped more than anything else I have been on. But I have not found another doctor willing to prescribe toradol again since then. None of these specialists stay consistent among themselves. Any doctor I have asked about toradol since then does not want to prescribe the medication. It really is frustrating to know that something would work, yet have doctors refuse to prescribe it. - Amanda W (team member) 
1. Amanda Osowski Moderator & Contributor
 <inline-mention username="Amanda Workman" user-id="3715820"/> YES! I completely agree. I am afraid to change doctors for this primary reason!
Holly Harding Moderator & Contributor
Hi Amanda- Thank you so much for sharing this experience with us. I'm grateful that you've created a resource that addresses the use and efficacy of Ketorolac Injectables. I have been injecting myself with 60mg of Ketorolac when faced with an attack that won't respond to my usual rescue meds (triptans and then opioids). Like you, I have botox and CGRP (emgality) injections which I use as preventatives. The Ketorolac is my last line of defense and I've found it generally works well and keeps me out of the ER. Like you, I'm not squeamish about injecting myself after so many years of doing so. Still, as I have to inject myself at least once a week, I find it tricky to inject in new places that don't result in scar tissue. For a while I was trying to inject into my rear upper hip - as instructed by my doctor- but it is a reach and I sometimes inject subQ rather than intramuscular by mistake. When I have done that, a little pocket of scar tissue results (the size of a pea or up to almost a grape). These either never dissipate or take years to do so. To this end, my body is riddled with these little bumps. After consulting with a nurse about the issue, I've recently taken to injecting into my upper arm and, while more painful due to the amount of fluid into my fairly skinny arm, I haven't gotten any of these lumps from doing so. I did want to also share that recently my pharmacy was able to find 60mg vials so I don't have to use two anymore. I find this helps slightly with the sharpness of the needle because it doesn't get poked into two 30mg vials with thick rubber tops before going into my skin. I find that sometimes those two draws can dull the needle. At any rate- this content, specifically about ketorolac, is most helpful as it's been missing from our site. I suggest on a regular basis to our community members that Ketorolac be considered as part of an emergency plan yet haven't had any deeper resources to link to that suggestion. Thanks for creating this. Warmly- Holly <a href='http://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team.
Amanda Osowski Moderator & Contributor
<inline-mention username="Holly Harding" user-id="3755969"/> Thank you so much for sharing this! I typically inject in my thigh or have my husband do my upper but cheek, but didnt think about the dulling of the needle from gong into two separate vials. I appreciate all of the info you shared and glad this article will be helpful! Warmly, Amanda (Team Member )

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