Ketorolac is a nonsteroidal anti inflammatory drug (NSAID). Ketorolac tromethamine inhibits synthesis of prostaglandins and may be considered a peripherally acting analgesic. The biological activity of ketorolac is associated with the S-form. Ketorolac tromethamine possesses no sedative or anxiolytic properties.
Indications
Ketorolac tromethamine is indicated for the short term not more than 2 days (but if needed can be used up to 5 days) in management of moderately severe, acute pain that requires analgesia at the opioid level, usually in a postoperative setting. Ketorolac tromethamine IV/IM has been used concomitantly with morphine and meperidine, and has shown an opioid sparing effect.
Dosage
Patients <65 years of age : the recommended dose is 30 mg ketorolac tromethamine IV/IM every 4-6 hours. The maximum daily dose should not exceed 90 mg.
Patients >65 years of age, renally impaired patients, and patients less than 50 kg, the recommended dose is 30 mg ketorolac tromethamine IV/IM every 4-6 hours, The maximum daily dose for these populations should not exceed 60 mg.
Contraindications:
- In patients with active peptic ulcer disease, in patients with recent gastrointestinal bleeding or perforation an in patients with a history of peptic ulcer disease or gastrointestinal bleeding.
- In patients with advanced renal impairment, or in patients at risk of renal failure due to volume depletion.
- In labor and delivery because, through its prostaglandin synthesis inhibitory effect, it may adversely affect fetal circulation and inhibit uterine contraction, thus increasing the risk of uterine contraction, thus increasing the risk of uterine hemorrhage.
- In patients with previously demonstrated hypersensitivity to ketorolac tromethamine, or allergic manifestations to aspirin or other non-steroidal anti inflammatory drugs (NSAIDs)
- For neuraxial (epidural or intrathecal) administration due to its alcohol content.
