Ketorolac has a pronounced analgesic effect, also has anti-inflammatory and moderate antipyretic effects.
The mechanism of action is associated with non-selective inhibition of cyclooxygenase 1 and 2 enzyme activity, mainly in peripheral tissues, the consequence of which is inhibition of prostaglandin biosynthesis – modulators of pain sensitivity, thermoregulation and inflammation. Ketorolac is a racemic mixture of [-]S and [+]R enantiomers, the analgesic effect being due to the [-]S form.
The drug does not affect opioid receptors, does not depress respiration, is not addictive, and has no sedative or anxiolytic action.
In terms of analgesic effect the drug is comparable to morphine and is significantly superior to other NSAIDs.
After oral administration, the onset of analgesic effect is noted in 1 hour respectively, the maximum effect is reached after 1-2 hours.
Moderate to severe pain syndrome:
- Postoperative pain,
- Joint pain in injuries with ligament rupture,
- sprains; back and muscle pain.
One tablet contains ketorolac tromethamine – 10 mg.
How to take, the dosage
In m/m, v/v, in children only in injections.
The dose is chosen individually, taking into account the severity of the pain syndrome.
In case of per oral administration, a single dose is 10-30 mg; the interval between the injections is 4-6 hours.
The maximal duration of preparation is 5 days.
Maximal doses: when administered by injection, 90 mg/day; for patients with body weight less than 50 kg, with renal dysfunction and for patients older than 65 years – 60 mg/day.
Ketorolac is taken orally, once or repeatedly depending on the severity of the pain syndrome.
The single dose is 10 mg; if repeatedly taken, it is recommended to take 10 mg up to 4 times a day depending on the severity of the pain; the maximum daily dose should not exceed 40 mg.
When taken orally, the duration of the course should not exceed 5 days.
In concomitant use of ketorolac with other NSAIDs may develop additive side effects; with pentoxifylline, anticoagulants (warfarin, heparin in low doses) – possible increased risk of bleeding; with ACE inhibitors – possible increased risk of renal dysfunction; with probenecid – ketorolac concentration in plasma and half-life increase; with lithium preparations – possible decrease of renal clearance of lithium and increase of its concentration in plasma; with furosemide – decrease of its diuretic effect.
When using ketoralac, the need for the use of opioid analgesics for pain relief is reduced.
With caution, use in patients with hepatic and renal dysfunction, chronic heart failure, arterial hypertension, patients with gastrointestinal erosive ulcers and gastrointestinal bleeding in the history, clotting disorders in the history.
Caution should be exercised when using ketorolac in the postoperative period in cases where particularly careful hemostasis is required (including after prostate resection, tonsillectomy, in cosmetic surgery) and in patients of advanced age because the half-life of ketorolac is longer and plasma clearance may decrease. In this category of patients, it is recommended to use ketorolac in doses near the lower limit of the therapeutic range.
In case of symptoms of liver damage, skin rash, eosinophilia, ketorolac should be stopped. Ketorolac is not indicated for use in chronic pain syndrome.
If during treatment with ketorolac drowsiness, dizziness, insomnia or depression occur, special caution should be exercised during potentially dangerous activities that require increased attention and rapid psychomotor reactions.
- hypersensitivity (including to aspirin and other NSAIDs. NSAIDs),
- nasal polyps,
- angioneurotic edema,
- bronchial asthma, gastric and duodenal ulcer,
- renal dysfunction,
- high risk of postoperative bleeding or incomplete stopping of bleeding,
- disorder of hematopoiesis,
- cerebral hemorrhage,
- early childhood (under 2 years).
- stomach pain,
- stomach and intestinal mucosa damage,
- pain at the injection site.
Symptoms (single administration): abdominal pain, nausea, vomiting, gastrointestinal erosive and ulcerative lesions, renal dysfunction, metabolic acidosis.
Treatment: symptomatic (maintenance of vital body functions). Dialysis is ineffective.
Dolac, Ketorol, Ketonov, Ketorolac, Ketorolac Rompharm
|Conditions of storage|
In a light-protected place at a temperature of 15 to 25 ° C. Store out of the reach of children.
Sintez OAO, Russia
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