Products
Ketorolac commercially available in the form of film-coated tablets, as a solution for injection (Tora-Dol), and as eye drops (Acular, generic). It has been approved in many countries since 1992.
Structure and properties
Ketorolac (C15H13NO3, Mr = 255.7 g/mol) is present in drugs in the form of the salt ketorolactrometamol (= ketorolactromethamine), see also under trometamol. The pyrrolizinecarboxylic acid derivative is structurally related to indomethacin and exists as a racemate that is soluble in water. The -enantiomer is responsible for the analgesic effects.
Effects
Ketorolac (ATC M01AB15, ATC S01BC05) has analgesic, anti-inflammatory, and antipyretic properties. The effects are due to inhibition of prostaglandin synthesis by nonspecific inhibition of cyclooxygenase. There is controversy in the literature as to whether parenteral ketorolac is beneficial for the treatment of pain after surgery. According to Arora et al (2007), oral ibuprofen, for example, can be used just as well for this purpose.
Indications
Ketorolac is used systemically to treat pain of various causes. The solution for injection is approved in many countries for the treatment of pain after surgery and may be used in children as young as 2 years of age when opioids are contraindicated. In the eye, ketorolac is used to prevent and treat pain and inflammation after cataract surgery.
Dosage
According to the SmPC. Because of the numerous possible adverse effects, the dose for systemic use should be kept as low and and the duration of treatment as short as possible. The drug is intended for short-term treatment only.
Contraindications
Full details of precautions and interactions can be found in the drug label.
Adverse effects
The most common possible adverse effects include headache, nausea, dyspepsia, abdominal pain and discomfort, purpura, drowsiness, drowsiness, sweating, dizziness, high blood pressure, constipation, diarrhea, flatulence, bloating, stomatitis, vomiting, pruritus, exanthema, swelling, and pain at the injection site. Like other NSAIDs, ketorolac can cause serious side effects such as gastrointestinal ulcers, cardiovascular disease, and kidney disease. When used on the eye, stinging and burning are often observed on dropping in, as well as other local side effects.
