Ketorolac Tromethamine: Brands, Price & Uses in Bangladesh

Ketorolac Tromethamine is a nonsteroidal anti-inflammatory drug (NSAID) approved for the short-term management of pain. It is intended for brief courses of therapy only and is not indicated for minor or chronic pain conditions.

Established (FDA-approved) uses

• Short-term management of moderately severe acute pain (oral and injectable forms) requiring analgesia at the opioid level, usually used as continuation therapy after initial treatment with injectable Ketorolac Tromethamine, or as an alternative to opioids. Total combined duration (oral plus injectable) must not exceed 5 days.
• Ophthalmic solution: temporary relief of ocular itching due to seasonal allergic conjunctivitis; treatment of postoperative inflammation following cataract surgery; and reduction of ocular pain, burning/stinging, and photophobia after corneal refractive surgery.

Not indicated for

• Minor pain, chronic pain conditions, or long-term use.
• Use as a first-line or sole analgesic in pediatric patients (see Pediatric Uses).

Ketorolac Tromethamine is not an antibiotic and has no role in treating infections.

Ketorolac Tromethamine dosing depends on the route, indication, age, body weight, and renal function. The combined total duration of all routes (oral plus injectable) must never exceed 5 days due to increasing risk of serious gastrointestinal, renal, and bleeding complications with prolonged use.

Oral (tablet) — continuation therapy for moderately severe acute pain

Intramuscular (IM) or Intravenous (IV) injection — moderately severe acute pain

Ophthalmic solution

• Allergic conjunctivitis: One drop of the affected eye(s) four times daily.
• Post-cataract surgery inflammation: One drop of the operated eye four times daily beginning 24 hours after surgery and continuing through the first 2 weeks post-surgery (per specific product labeling).

Renal or hepatic adjustment: Ketorolac Tromethamine is contraindicated in advanced renal impairment and in patients at risk of renal failure from volume depletion; a reduced dose (as above) is required in mild-to-moderate renal impairment, low body weight, and the elderly. No well-established dose adjustment exists for hepatic impairment; use with caution and avoid in significant hepatic disease.

Side effects associated with Ketorolac Tromethamine range from common and mild to rare but serious:

Common

• Gastrointestinal: dyspepsia, nausea, abdominal pain, diarrhea.
• Central nervous system: headache, dizziness, drowsiness.
• Edema and mild elevation of liver enzymes.
• Local injection-site pain (injectable form); transient stinging/burning (ophthalmic form).

Serious (less common but important)

• Gastrointestinal ulceration, bleeding, or perforation (can occur without warning symptoms).
• Acute renal failure, interstitial nephritis, or renal papillary necrosis.
• Increased bleeding tendency, prolonged bleeding time, purpura.
• Hypersensitivity reactions including rash, urticaria, bronchospasm, and rarely anaphylaxis, Stevens-Johnson syndrome, or toxic epidermal necrolysis.
• Hepatic dysfunction or, rarely, hepatic failure.
• Cardiovascular thrombotic events (myocardial infarction, stroke), especially with longer use.
• Aseptic meningitis (rare).

Patients should seek prompt medical attention for signs of GI bleeding (black or bloody stools, vomiting blood), unexplained bruising/bleeding, severe skin reactions, or reduced urine output.