Ketorolac Tromethamine(kee’ toe role ak)
Acular LS, Acuvail, Apo-Ketorolac (CAN), Apo-Ketorolac Injectable (CAN), Ketorolac (CAN), Sprix, Toradol (CAN), Tromethamine Injection (CAN)
PREGNANCY CATEGORY C
(FIRST AND SECOND TRIMESTERS)
PREGNANCY CATEGORY D
(THIRD TRIMESTER)
Drug Classes
Antipyretic
Nonopioid analgesic
NSAID
Therapeutic Actions
Anti-inflammatory and analgesic activity; inhibits prostaglandins and leukotriene synthesis.
Indications
Short-term management of pain (up to 5 days)
Ophthalmic: Relief of ocular itching due to seasonal conjunctivitis and relief of postoperative inflammation and pain after cataract surgery
Contraindications and Cautions
Contraindicated with significant renal impairment, during labor and delivery, lactation; patients wearing soft contact lenses (ophthalmic); aspirin allergy; concurrent use of NSAIDs; active peptic ulcer disease, recent GI bleed or perforation, history of peptic ulcer disease or GI bleeding; hypersensitivity to ketorolac; as prophylactic analgesic before major surgery; treatment of perioperative pain in CABG; suspected or confirmed cerebrovascular bleeding; hemorrhagic diathesis, incomplete hemostasis, high risk of bleeding; use with probenecid, pentoxyphylline.
Use cautiously with impaired hearing; allergies; hepatic, CV and GI conditions.
Available Forms
Ophthalmic solution—0.4%, 0.45%, 0.5%; tablets—10 mg; injection—15 mg/mL, 30 mg/mL, 60 mg/2 mL, 300 mg/100 mL; nasal spray—15.75 mg/spray
Dosages
For short-term use only (up to 5 days). Potent NSAID with many adverse effects.
Adults
Parenteral
Single-dose treatment: 60 mg IM or 30 mg IV.
Multiple-dose treatment: 30 mg IM or IV every 6 hr to a maximum 120 mg/day.
Oral
Transfer to oral: 20 mg PO as a first dose for patients who received 60 mg IM or 30 mg IV as a single dose or 30-mg multiple dose, followed by 10 mg every 4–6 hr; do not exceed 40 mg/24 hr.
Nasal spray
Patients younger than 65 yr: 1 spray (15.75 mg) in each nostril every 6–8 hr; maximum daily dose, 126 mg.
Patients 65 yr and older, patients with renal impairment, and patients weighing less than 50 kg: 1 spray in one nostril every 6–8 hr; maximum daily dose, 63 mg.
Ophthalmic
Itching from allergic conjunctivitis: 1 drop qid.
Acular: For cataract surgery, begin 1 drop qid 24 hr after surgery and continue for 2 wk.
Acular LS: 1 drop qid prn for burning and stinging for up to 4 days after surgery. For pain and photophobia, use for 3 days.
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