Ketorolac trometamol is a Medicine belongs to Non Sterodial Anti- Inflammatory Drugs group whose information about Brand can be referenced from   Book : Martindale    Page : 81   Edition : 38,

  ►   Brandname : Cadolac,Ketanov,Acuvail,Acular,Toradol

  ►  Strength : Tablet with 10  mg, Injection with 15  mg/ml, Injection with 30  mg/ml, Ophthalmic Solution with 0.4  %, Ophthalmic Solution with 0.5  %,

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 655   Edition : 12,
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : Topical, Oral, IM, IV,
Reference :-   Book : Martindale    Page : 80   Edition : 38,

Dosing of Medicine differ in Adult & Pediatrics ↓


Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 Postoperative pain IV 10 mg Injection Followed by 10 to 30 mg every 4 to 6 hours as required, although ketorolac may be given as often as every 2 hours in the initial postoperative period if required. The total maximum daily dose is 90 mg (60 mg in the elderly, patients with mild renal impairment, and in those weighing less than 50 kg). Intravenous injections should be given over at least 15 seconds.
2 Postoperative pain Oral 20 mg Tablet (10 mg in the elderly, the renally impaired, and those weighing under 50 kg), followed by 10 mg every 4 to 6 hours to a maximum of 40 mg daily.
3 Ocular itching Topical 0.5 % Eye Drop
4 Cystoid macular oedema Topical 0.5 % Eye Drop
5 Postoperative pain IM 60 mg Injection or a single intravenous dose of 30 mg, or a multiple-dose regimen comprising 30 mg every 6 hours intramuscularly or intravenously, up to a maximum of 120 mg daily.
6 Moderate to moderately severe acute pain intranasal 15.75 mg Spray t.i.d/q.i.d In each nostril.

Ref :-  Book : Martindale    Page : 80   Edition : 38,




Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  
1 Conjunctivitis 3 Year more than 3 Year Topical 1 gtt (drops) Ophthalmic Solution q.i.d.
2 Postoperative pain 2 Year 16 Year IM 1 mg/kg Injection
3 Postoperative pain 6 Year 16 Year IV 0.5 1 mg/kg Injection

Ref :- Book : Nelson's textbook of Pediatrics    Page : 811   Edition : 19, Martindale    Page : 80   Edition : 38,
►  Side Effect : gastrointestinal disturbance, gastrointestinal bleeding, perforation, Peptic Ulceration, hypersensitivity reactions, anaphylactic reactions, Rashes, bronchospasm, laryngeal oedema, hypotension, Dizziness, headache, sweating, mental and sensory changes, psychotic reactions, dry mouth, thirst, fever, convulsion, myalgia, aseptic meningitis, hypertension, Dyspnoea, pulmonary oedema, bradycardia, chest pain, palpitations, fluid retention increases in blood urea and creatinine, acute renal failure, oedema, hyponatraemia, hyperkalaemia, urinary frequency or retention, nephrotic syndrome, flank pain with or without haematuria, purpura, thrombocytopenia, epistaxis, inhibition of platelet aggregation, increased bleeding time, postoperative wound haemorrhage, haematoma, , flushing or pallor, and pancreatitis. Severe skin reactions including Stevens-Johnson syndrome and Lyell’s syndrome , Liver function changes may occur; hepatitis and liver failure. Pain at the site of injection. Ketorolac eye drops may produce transient stinging and other minor symptoms of ocular irritation and corneal toxicity.,
Ref :-   Book : Martindale    Page : 80   Edition : 38,

►  Drug Interaction : Drug interaction of Ketorolac trometamol is with Non Sterodial Anti- Inflammatory Drugs , Anticoagulant ,  Probenecid , Pentoxifylline , Aspirin, Heparin ,
Ref :-   Book : Martindale    Page : 81   Edition : 38,


  ►    Mechanism of Drug Drug Interaction :  Ketorolac should not be given to patients already receiving anticoagulants or to those who will require prophylactic anticoagulant therapy, including low-dose heparin. The risk of ketorolac-associated bleeding is also increased by other NSAIDs or aspirin and by pentoxifylline and use together should be avoided. Probenecid increases the half-life and plasma concentrations of ketorolac. ,
Ref :-   Book : Martindale    Page : 81   Edition : 38,


►  Contraindication : Patients with a history of hypersensitivity to aspirin or other NSAIDs, a history of asthma, nasal polyps, bronchospasm, or angioedema, a history of peptic ulceration or gastrointestinal bleeding, with moderate or severe renal impairment, hypovolaemia or dehydration. , Pregnancy, Breast feeding, Ketorolac should not be given to patients with coagulation or haemorrhagic disorders or those with confirmed or suspected cerebrovascular bleeding. , contra-indicated as a prophylactic analgesic before surgery and for intraoperative use ., caution in heart failure, hepatic impairment and conditions leading to reduction in blood volume or in renal blood flow. Withdrawn if hepatotoxicity develop., It should also not be given postoperatively to those who have undergone procedures with a high risk of haemorrhage.,
Ref :-   Book : Martindale    Page : 81   Edition : 38,
  ►  Mechanism of Action :   Infl ammatory states are often associated with the production of prostaglandins, which are important mediators of both peripheral (left) and central (right) pain sensitization. In the periphery, prostaglandins produced by infl ammatory cells sensitize peripheral nerve terminal prostaglandin (EP ) receptors, making them more responsive to a painful stimulus. In central pain pathways, cytokines released in response to infl ammation induce prostaglandin production in the dorsal horn of the spinal cord. These prostaglandins sensitize secondary nociceptive neurons and thereby increase the perception of pain. Nonsteroidal anti-infl ammatory drugs (NSAIDs) block peripheral and central sensitization mediated by prostanoids that are released in infl ammation; NSAIDs also reduce the extent of infl ammation.,
Ref :-   Book : Principle of Pharmacology (The Pathophysiologic Basis of Drug Therapy)    Page : 276   Edition : 3,

Pathway of Dietry Product


​   ► Act.Comp / Nutrient / Food / Herb as follows :- Primrose oil with Another pathway,

  ►  Pathway with its reference as follows :-
  • phenolic compounds have Anti-inflammatory effect --- (Kokate, C.K. and A.p. Purohit. Pharmacognosy. Nirali prakashan: Chennai, 2013. Print. )

  •   ►  URL -- http://freepharmadownloads.blogspot.com/2013/02/pharmacognosy-ckkokate-free-download.html,


    Dietry Substance Interactions


    ​   ► This Medicine interact with :- NA



    ContraIndication Dietry Substance


    ​   ► This Medicine contraindicate with :- LITHIUM with Most NASDs inhibit the exretion of lithium from the body , resulting in higher blood levels of the mineral , though sulindac .,

      ►  Reference :-
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press

  •   ►  URL -- http://www.lifestyle-clinic.net/wp-content/uploads/2013/07/A-Z_Guide.pdf,

    ►   Route of Elimination :   Fecal, Renal,
    Ref :-   Book : Martindale    Page : 81   Edition : 38,


    ►    Plasma Half-life :   Min value :-   4 to 6 hours, but is about 6 to 7 hours in the elderly and 9 to 10 hours in patients with renal dysfunction.,    Max value :-   NA
    Ref :-   Book : Martindale    Page : 81   Edition : 38,


    ►    Peak Plasma Concentration :   Min value :-   30,    Max value :-   60 minutes,
    Ref :-   Book : Martindale    Page : 81   Edition : 38,