1 mL Single-Dose Vial Mayo Clinic facts about coronavirus disease 2019 (COVID-19), Our COVID-19 patient and visitor guidelines, plus trusted health information, Mayo Clinic Health System patient vaccination updates. Ketorolac tromethamine and its metabolites are eliminated primarily by the kidneys, which, in patients with reduced creatinine clearance, will result in diminished clearance of the drug (see CLINICAL PHARMACOLOGY). You will receive your first doses of ketorolac by intravenous (into a vein) or intramuscular (into a muscle) injection in a hospital or medical office. Advise patients to be alert for the symptoms of congestive heart failure including shortness of breath, unexplained weight gain, or edema and to contact their healthcare provider if such symptoms occur (see. (See Kinetics in Special Populations for use of intravenous dosing of ketorolac tromethamine in pediatric patients.). Race There are no adequate and well-controlled studies of ketorolac tromethamine in pregnant women. Pharmacology, adverse reactions, warnings and side effects. Never heard of patients coming in with nodule-like areas from injection. There is poor correlation between creatinine clearance and total ketorolac tromethamine clearance in the elderly and populations with renal impairment (r = 0.5). 25 x 1 mL Single-Dose Vials Avoid the use of ketorolac tromethamine in patients with a recent MI unless the benefits are expected to outweigh the risk of recurrent CV thrombotic events. Hallucinations have been reported when ketorolac tromethamine was used in patients taking psychoactive drugs (fluoxetine, thiothixene, alprazolam). Data sources include IBM Watson Micromedex (updated 2 Feb 2021), Cerner Multum™ (updated 3 Feb 2021), ASHP (updated 29 Jan 2021) and others. 14 It should also be noted that clearance in children is … Physicians, when prescribing ketorolac tromethamine, should inform their patients or their guardians of the potential risks of ketorolac tromethamine treatment (see Boxed WARNING, WARNINGS, PRECAUTIONS, and ADVERSE REACTIONS sections), instruct patients to seek medical advice if they develop treatment-related adverse events, and advise patients not to give oral ketorolac tromethamine to other family members and to discard any unused drug. Issued: February 2019. India Use minimum effective dose for the individual patient. Therefore, concomitant use of ketorolac tromethamine and probenecid is contraindicated. In patients with renal disease, the AUC∞ of each enantiomer increased by approximately 100% compared with healthy volunteers. Ketorolac tromethamine is CONTRAINDICATED in patients currently receiving aspirin or NSAIDs because of the cumulative risk of inducing serious NSAID-related side effects. Before doctors began using the hip as an injection site, they used the … Although the absolute rate of death declined somewhat after the first year post-MI, the increased relative risk of death in NSAID users persisted over at least the next four years follow-up. Although serious GI tract ulcerations and bleeding can occur without warning symptoms, patients should be alert for the signs and symptoms of ulcerations and bleeding, and should ask for medical advice when observing any indicative sign or symptoms including epigastric pain, dyspepsia, melena, and hematemesis. Ketorolac (Toradol) Dose in acute moderately severe pain in patients ≥50 kg: Note: The maximum combined duration of treatment (for parenteral & oral) is 5 days; Dose or frequency should not be increased. In adults, the use of oral ketorolac tromethamine is only indicated as continuation therapy to intravenous or intramuscular dosing of ketorolac tromethamine. Forced diuresis, alkalization of urine, hemodialysis or hemoperfusion may not be useful due to high protein binding. These are not all the possible side effects of NSAIDs. Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs, and may occur following an overdose. It belongs to the group of medicines called nonsteroidal anti-inflammatory drugs (NSAIDs). if you had an asthma attack, hives, or other allergic reaction with aspirin or any other NSAIDs. Follow your doctor's orders or the directions on the label. Patients taking thiazides or loop diuretics may have impaired response to these therapies when taking NSAIDs. For more information go to www.auromedics.com or call 1-888-238-7880. Pediatric Patients Impaired Renal Function The plasma clearance of ketorolac is 0.021 to 0.037 L/h/kg. Issued: February 2019, Rx only NDC 55150-339-01 If ketorolac tromethamine is used in patients with a recent MI, monitor patients for signs of cardiac ischemia. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Ketorolac is used for the short-term treatment of moderate to severe pain. If these occur, patients should be instructed to seek immediate emergency help (see. Therefore, peri-operative use of ketorolac tromethamine should be avoided and postoperative use be undertaken with caution when hemostasis is critical (see PRECAUTIONS). In postmarketing experience there have been reports of a possible interaction between ketorolac tromethamine intravenous/intramuscular and nondepolarizing muscle relaxants that resulted in apnea. Ketorolac tromethamine is contraindicated in patients with previously demonstrated hypersensitivity to ketorolac tromethamine. NSAIDs, including ketorolac tromethamine, can cause serious skin adverse events such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. (see also Boxed WARNING) Convert to oral treatment once possible. Drug information provided by: IBM Micromedex. Physicians and patients should remain alert for the development of such events, throughout the entire treatment course, even in the absence of previous CV symptoms. After 1 day of dosing (10 mg every 6 hours), the maximum milk concentration was 7.9 ng/mL, and the maximum milk-to-plasma ratio was 0.025. NSAIDs, including ketorolac tromethamine, can lead to onset of new hypertension or worsening of pre-existing hypertension, either of which may contribute to the increased incidence of CV events.