The drug became popular due to a strong analgesic, moderate anti-inflammatory and antipyretic effects. Ketorol helps with joint, headache, muscle pain. The tool is used in surgery, dentistry, orthopedics, neurology, gynecology, oncology.

Release forms and composition

The main substance of the medication Ketorolac tromethamine is one of the derivatives of pyrrolysine carboxylic acid. The pharmaceutical composition appeared in 1980. A relatively new drug is included in the group of non-steroidal anti-inflammatory drugs (NSAIDs or NSAIDs).

 

Ketorol tablets are intended for oral administration. Under the green membranous membrane is a compressed white powder. The content of ketorolac in this dosage form is 10 mg. Auxiliary components are lactose, cellulose and other compounds.

Ketorol injections are called in everyday life a solution for i / m and iv injection. The volume of the ampoule is 1 ml, the concentration of ketorolac in the liquid is 30 mg / ml. Auxiliary components: chloride and sodium hydroxide, ethanol, etc.

The concentration of the active ingredient in the gel is 2%, which is 2 g in every 100 g of the drug. The total content of ketorolac in a tube weighing 30 g is 600 mg. In the reference books of medicines (radar and Vidal) there are no Ketorol suppositories among the forms of release of Ketorolac. The same situation in Belarus, Ukraine.

Pharmacological action, pharmacodynamics and pharmacokinetics

Ketorolac inhibits cyclooxygenase, an enzyme necessary for the synthesis of prostaglandins. These are mediators responsible for the development of the inflammatory process, the accompanying pain and heat. The effect on COX is due to the analgesic and anti-inflammatory effects of NSAIDs.

The pharmacological action of ketorolac has determined the scope of its use - symptomatic treatment of pain.

Ketorol is an analgesic of non-narcotic nature. However, the strong analgesic effect of the drug is often compared with opioids. Unlike the latter, ketorolac does not affect the central nervous system, is not a tranquilizer.

After 4-10 minutes after absorption of the active substance into the blood, the pain syndrome is weakened. The therapeutic effect lasts from 6 to 8 hours.

The absorption of ketorolac does not depend on the intake or availability of food in the digestive tract. Over 50% of the active substance that enters the body is converted in the liver into metabolites that do not have physiological activity. Excretion in urine is more than 90%, less than 10% is excreted through the intestine.

What helps Ketorol?

The causes of the pain syndrome in which this drug is prescribed may be different. Most often, acute pain develops with inflammation, trauma, surgery, edema, muscle spasms.

Ketorol is used for short-term treatment of pain of moderate intensity:

  • with traumatic lesions, including bruises, dislocations, damage to ligaments, tendonitis, bursitis, synovitis;
  • with osteochondrosis, radiculitis;
  • myalgia, arthralgia, neuralgia;
  • with rheumatic diseases;
  • with oncology.

The drug helps in case of moderate and severe postoperative pain in patients in combination with low doses of narcotic analgesics. Ketorol is prescribed to reduce inflammation of the eye after cataract removal in adults.

What helps Ketorol gel:

  • pain during injuries, damage to ligaments;
  • rheumatic diseases;
  • post-traumatic pain;
  • myalgia and arthralgia;
  • radiculitis;
  • neuralgia.

Ketorol does not affect the nature of the course of the causative disease. Symptomatic only reduces the intensity of the inflammatory process, pain, due to injuries, inflammation.

Instructions for use and dosage

The choice of form of release of the drug is dictated by the main indication and related circumstances. Anesthesia is achieved faster with the / m and / in the introduction. The latter method is used mainly in hospitals and nursing homes.

Ketorol tablets

Usually, one tablet is taken for toothache, which corresponds to 10 mg of ketorolac. For injuries, myalgia and other indications, an increase in dosages may be required. Take one tablet every 4-6 hours. The maximum allowable daily dose is 40 g.

The duration of treatment for most NSAIDs is 3–7 days.

Ketorol is not prescribed for children under 12 years of age. Elderly people may need to reduce the dose recommended for adults to avoid the adverse effects of the drug on the digestive tract.

Solution for intramuscular and intravenous administration

One Ketorol ampoule contains 30 mg of the active ingredient. Experts suggest parenteral administration starting with a dose of 10 mg, then use 10-30 mg every 4-6 hours. The maximum single dose for the treatment of patients from 16 to 64 years old is 60 mg of ketorolac (2 ampoules of Ketorol), the highest daily dose is 90 mg (3 ampoules).

If the patient's body weight is less than 50 kg and / or he is more than 65 years old, then 15 or 30 mg (½ or 1 ampoule) is used once. A maximum of 2 ampoules per day can be administered.

Gel for external use

A single dose of ketorolac corresponds to a column of gel with a length of about 1.5–2 cm. The product is applied to clean, dry, undamaged skin within the area of ​​pain, evenly distributed by the fingertips, rubbed with soft massaging movements. Apply the gel no more than 4 times a day.The course of treatment is from 3 to 10 days.

During pregnancy and breastfeeding

The drug is not prescribed to women expecting a baby, as well as during childbirth. Ketorolac has an undesirable effect on the contractile function of the uterus, passes through the placenta (10% of the dose taken by the expectant mother). The use of the drug can lead to intrauterine pulmonary hypertension in newborns. If the doctor considers it necessary, he will prescribe Ketorol tablets or injections in the I and II trimesters of pregnancy.

Ketorolac is strictly contraindicated in the last three months of pregnancy and during lactation.

If a nursing mother takes a Ketorol tablet, then the active ingredient passes into breast milk. The medicine reaches its maximum concentration after 2 hours. Before using the gel, pregnant or lactating women should consult a gynecologist or pediatrician.

Drug interaction

Simultaneous administration can enhance the negative effect of drugs on the gastrointestinal mucosa. Concomitant oral or parenteral administration of Ketorol with other NSAIDs should be avoided, since in this case the risk of gastrointestinal bleeding increases.

And also a combination of ketorolac with the following medicines is undesirable:

  • anticoagulants such as heparin and warfarin;
  • platelet aggregation inhibitors;
  • corticosteroids (GCS);
  • calcium preparations;
  • penoxifylline.

The combined use of ketorolac with methotrexate, lithium salts leads to an increase in the concentration and toxicity of the latter. With simultaneous treatment, Ketorol reduces the effectiveness of antihypertensive drugs and diuretics. Paracetamol and ketorolac can be used together for no longer than 2 days. The combination of Ketorol with narcotic painkillers can significantly reduce the dose of opioids.

Ketorol Compatibility with Alcohol

Ketorolac is not taken with ethanol. Both substances irritate the gastrointestinal mucosa to varying degrees, which creates a risk of gastrointestinal bleeding.

Alcohol increases the rate of absorption and excretion of NSAIDs. The analgesic effect, for which Ketorol is taken, develops faster and ends. There is a need to increase doses, and this is fraught with increased side effects and overdose.

It is dangerous to combine ketorolac treatment with alcohol for several other reasons. For example, the combination is dangerous for the liver, which is responsible for the metabolism of drugs and ethanol. At the same time, the load on the kidneys increases, through which the decomposition products are excreted.

Contraindications, side effects and overdose

Ketorol is not usually used for mild pain. The medicine is used under medical supervision. Ketorol treatment is contraindicated in case of hypersensitivity to the main and auxiliary components, allergies to other NSAIDs, in the last trimester of pregnancy, during childbirth, lactation. Tablets and injections are not prescribed for children under 16 years old, gel - for adolescents under 12 years old. Contraindications are mainly severe lesions of the gastrointestinal tract, other systems and organs, renal failure.

 

Like other NSAIDs, ketorolac has side effects. Typical negative manifestations of treatment are nausea, abdominal pain, dyspepsia (12–13%), diarrhea (9%). Less common are more dangerous side effects: gastric ulcers and bleeding, laryngeal edema, anaphylaxis.

Long-term uncontrolled intake of Ketorol can contribute to the development of allergic disease, dermatosis, asthma, pancreatitis, hepatitis. If any of the listed side effects appear, it is necessary to stop treatment and consult a doctor.

Exceeding the dose of ketorolac may be accompanied by nausea, abdominal pain, abdominal cramping, and vomiting. An overdose of Ketorol is one of the causes of jumps in blood pressure, ulceration, perforation of the stomach, gastroduodenal bleeding, renal failure, anaphylaxis, respiratory depression. Seek immediate medical attention.

Analogues of the drug

Ketorolac is part of domestic and foreign drugs. In pharmacies you can find cheap analogs with almost identical composition - generics. The cost of Indian drugs produced under the general brand name Ketorol: solution in ampoules - 120 rubles. (10 pcs.), Tablets - 36 rubles. (20 pcs.), Gel - 255 rubles. (30 g).

Full structural analogues, price (rub.):

  • Ketorolac (Russia), tablets - from 15 to 40, ampoules - 80;
  • Ketanov (Romania), tablets - 70, ampoules - 125;
  • Ketorolac Romopharm (Romania), ampoules - 105;
  • Dolak (India), tablets - 35, ampoules - 85.

In some cases, it is necessary to determine the benefits of Ketanov or Ketorol, which is better to use for pain. The preparations are complete structural analogues - they contain the same active ingredient in identical dosages. This means that the indications and contraindications, methods of use do not have serious differences. All the characteristics of Ketorol and Ketanov basically coincide, so the funds are interchangeable.

A similar mechanism of action is for group analogues of ketorolac. Indomethacin is closest in properties to Ketorol. Candles, various versions of tablets and gels provided a great demand for another related compound with a similar mechanism of action - diclofenac. However, it was this representative of NSAIDs that has undergone additional checks in recent years in connection with the increasing reports of a negative effect on the gastrointestinal tract, cardiovascular system, and blood formation.

Ketorolac has analgesic properties. Anti-inflammatory and antipyretic effects are less pronounced. Therefore, Ketorol is not a complete replacement for paracetamol, ibuprofen, aspirin, and vice versa.

Doctor of Medicine, researcher of the safety of NSAIDs treatment A. Karataev believes that there is more “for” than “against” the use of this group of drugs. The scientist notes the high bioavailability of ketorolac, the ability to quickly accumulate in plasma.

Ketorol and analogs in composition develop an analgesic effect comparable to the use of small doses of morphine or promedol. However, the action of ketorolac lasts longer than narcotic painkillers. Ketorol is not a sedative, non-addictive, rarely provokes unwanted effects with a short course of treatment.

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