Characteristics and Uses of Ketorolac

04 January, 2021
Ketorolac is a substance used for the short-term treatment of moderate to severe postoperative pain or for the treatment of pain caused by kidney colic.

Ketorolac trometamol is the active ingredient of the Tekac and Toradol medications that belong in the group of analgesics, anti-inflammatories, and antipyretics.

Furthermore, this drug is for the short-term treatment of moderate to severe postoperative pain or for the treatment of pain caused by kidney colic.

Characteristics and uses of ketorolac

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This drug inhibits the activity of cyclooxygenase and therefore the synthesis of prostaglandins. Thus, it has a lower anti-inflammatory effect than other NSAIDs at analgesic doses.

Ketorolac trometamol is available as an injectable solution and as tablets for oral intake:

  • The injectable presentation is for short-term treatment of moderate or severe postoperative pain and pain caused by nephritic colic.
  • Ketorolac trometamol tablets are for the short-term treatment of mild or moderate postoperative pain.

How to use ketorolac

People must adjust the dose of ketorolac tromethamine according to the severity of pain and patient response, aiming to deliver the lowest effective one.

Also, the recommended initial intramuscular or intravenous dose is 10 mg. According to this, the dose would be 10-30 mg every 4 to 6 hours, depending on the patient’s needs for pain control. Note that the recommended initial dose to relieve severe pain is 30 mg. The maximum recommended daily dose is 90 mg for young adults and 60 mg for seniors.

Treatment with trometamol ketorolac should begin in a hospital setting. In general, its maximum duration shouldn’t exceed 2 days. However, the total duration of treatment shouldn’t exceed seven days in the case of subsequent oral administration.

Professionals recommend a single dose of 30 mg parenterally for the treatment of colicky kidney pain. In most patients, treatment with ketorolac through the parenteral administration route should provide adequate relief.

In addition, people may use it in conjunction with opioid analgesics when the maximum recommended doses of ketorolac aren’t enough to relieve the intensity of the pain.

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Contraindications

Non-opioid analgesics.

This drug has a number of contraindications, among them:

  • Hypersensitivity to ketorolac trometamol or other NSAIDs
  • Active peptic ulcer
  • Angioedema or bronchospasm
  • Severe heart failure
  • Moderate to severe renal insufficiency
  • Coagulation disorders

Other contraindications are pregnancy, childbirth, breastfeeding – children under 16 years shouldn’t take it either. In addition, people using ketorolac should avoid other NSAIDs, ASAs, and anticoagulant therapy.

Possible side effects of ketorolac

Ketorolac in tablet form may have adverse gastrointestinal side effects such as peptic ulcer, perforation, or gastrointestinal bleeding. Thus, it could be deadly, particularly in vulnerable elderly people.

Other adverse effects may include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Gases
  • Constipation
  • Malaise
  • Abdominal pain

There may also be inflammation of the stomach along with bloody bowel movements and worsening of ulcerative colitis and Crohn’s disease.

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Other disorders that may be triggered by taking this medication include:

  • Firstly, metabolic or nutritional disorders, such as anorexia or increased potassium and sodium levels
  • Nervous system problems such as meningitis, seizures, dizziness, drowsiness, headache, hyperactivity, and a decreased ability to concentrate, as well as insomnia, tingling, and numbness.
  • Also, there may be weird dreams, altered thinking, anxiety, depression, euphoria, hallucinations, psychotic reactions, nervousness.
  • Renal and urinary problems such as acute kidney failure, kidney pain, increased frequency of urination, urinary retention, decreased urine production, and other signs of kidney inflammation.
  • Cardiac and vascular problems such as swelling, hypertension, heart failure, arrhythmias, hot flashes, palpitations, hypotension, chest pain, and pallor.
  • Problems in the breasts and reproductive system.
  • In addition, there may be hepatobiliary conditions such as altered liver tests, hepatitis, jaundice, and liver failure.
  • Also, problems in the musculoskeletal and connective tissue that manifest as muscle pain.
  • Finally, vision alterations and ringing in the ears.

Conclusion

The risk-benefit balance of ketorolac can be favorable as long as people strictly adhere to the authorized conditions of its use. In other words, people who use it must comply with the indications, dosage, and duration of treatment indicated by their physician.

  • Lopez-Alarcon, & Ibañez, D. A. (1998). Ketorolaco: Indicaciones terapéuticas y vías alternativas a las contempladas en la ficha farmacológica. Rev. Soc. Esp. Dolor.
  • Gómez-Rojas, J. P. (2013). Tramadol-ketorolaco versus tramadol-dexketoprofeno en pacientes postoperados de prótesis de cadera y rodilla. Revista Mexicana de Anestesiologia.

  • S??nchez-Zerme??o, M. E., Guevara-L??pez, U., Medina-Rodr??guez, F., Serratos-V??zquez, M. C., G??mez-Fuentes, S., & Espinosa-Betancourt, J. (2014). Analgesia postoperatoria en pacientes polifracturados con morfina-ketorolaco versus analg??sicos no opi??ceos. Revista Mexicana de Anestesiologia.