Ketorolac

Details About Generic Salt ::  Ketorolac 

Main Medicine Class:: Musculoskeletal Disorders , Pain   Sub Medicine Class ::  Analgesics , Anti inflammatory Drugs

3F. MISCELLANEOUS in 3. OCULAR
KETOROLAC
NSAID | ANALGESIC & ANTI-INFLAMMATORY, ANTI-PYRETIC
also comes under 12E. Analgesics & Anti-inflammatory Drugs in 12. Musculoskeletal Disorders & Pain,  
PK: A: Well absorbed D: ~13 L (Vd) M: Hepatic E: Urine (92%, ~60% as unchanged drug) & feces (~6%)

Indications & Dose: ALLERGIC CONJUNCTIVITIS (RELIEF OF OCULAR ITCHING) TP Adult Solution (as tromethamine 0.4% or 0.5%): Instill 1 drop (0.25mg) QID Child >3 yr: Same as adult dose | INFLAMMATION FOLLOWING CATARACT EXTRACTION TP Adult Solution (as tromethamine, 0.5%): Instill 1 drop (0.25mg) QID to affected eyes beginning 24h after surgery, continue for 2 wk Child >3 yr: Same as adult dose | PAIN FOLLOWING CORNEAL REFRACTIVE SURGERY TP Adult Solution (as tromethamine, 0.4%): Instill 1 drop QID (or as needed) to affected eye 4 days Child >3 yr: Same as adult dose | POST-OPERATIVE PAIN Acute/Moderate-to-severe PO Adult After the parenteral therapy, 20mg as initial dose followed by 10mg q4-6h, max 40mg/day. Combined duration of treatment (parenteral & PO) is limited to 5 days. Patients <50 kg: Refer elderly dosing Child >17 yr: Same as adult dose Elderly >65 yr: After the parenteral therapy, 10mg as initial dose followed by 10mg q4-6h, max 40mg/day Combined duration of treatment (parenteral & PO) is limited to 5 days | Acute/Moderate-to-severe IV Adult 30mg single dose or 30mg QID, max 120mg/day followed by oral therapy. Combined duration of treatment (parenteral & PO) is limited to 5 days. Patients <50 kg: Refer elderly dosing Child >16 yr: Same as adult dose Elderly >65 yr: 50% of the adult dose | Acute/Moderate-to-severe IM Adult 60mg single dose or 30mg QID, max 120mg/day followed by oral therapy. Combined duration of treatment (parenteral & PO) is limited to 5 days. Patients <50 kg: Refer elderly dosing Child >16 yr: Same as adult dose Elderly >65 yr: 50% of the adult dose

Contra: Hypersensitivity, active/history of PUD, recent/history of GI bleeding/perforation, renal dysfunction, prophylaxis before major surgery, suspected/confirmed cerebrovascular bleeding, hemorrhagic diathesis, incomplete hemostasis/high risk of bleeding, concurrent aspirin/other NSAIDs/probenecid/pentoxifylline, epidural/intrathecal administration, perioperative pain in CABG surgery setting, labor & delivery, incomplete hemostasis & patients at high risk for bleeding, aspirin-sensitive asthma, history of asthma/nasal polyps/bronchospasm/angioedema, hypovolemia/dehydration, intraoperative/postoperative use, severe HF, children with varicella

Precautions: Mild-to-moderate renal impairment, CVD, elderly, asthma, oral formulation in children, mild-to-moderate HF, hepatic impairment, conditions leading to reduction in blood volume/in renal blood flow, withdrawal drug if hepatotoxicity develops, HTN, patients with infect

ADR: Serious: Edema, HTN, GI bleeding/perforation/ulcer, acute pancreatitis, anaphylaxis, cholestatic jaundice, hypersensitivity reactions, hypotension, ARF, hyperkalemia, inhibition of platelet aggregation, postoperative wound hemorrhage, hematoma, severe skin reactions, hepatitis & liver failure, bleeding time increased, increased liver enzymes, tinnitus, corneal toxicity, Others: diaphoresis, Inj site pain, ocular irritation, heartburn, vomiting, anemia, Headache, GI pain, dyspepsia, nausea, dizziness, drowsiness, pruritus, purpura, rash, diarrhea, constipation, flatulence

DDI: Serious Dalteparin cause prolonged bleeding time, Probenecid reduces drug clearance & raises its levels

Diet: With food

Monitor: Weight gain, edema, renal function test, bleeding, bruising, evaluate GI effects (abdominal pain, bleeding, dyspepsia), mental confusion, disorientation, CBC & platelets, LFTs