Ketorol is an effective pain reliever. The medicine belongs to the group of anti-inflammatory non-steroidal drugs. In addition to the analgesic effect, the drug reduces inflammation and swelling. In addition, ketorol, the instructions indicate this, has antipyretic properties.
Contraindications
- Hypersensitivity to ketorolac or to any component of the drug;
- patients with active peptic ulcer disease, with recent gastrointestinal bleeding or perforation, with a history of peptic ulcer disease or gastrointestinal bleeding;
- bronchial asthma, rhinitis, angioedema or urticaria caused by the use of acetylsalicylic acid or other NSAIDs (due to the possibility of severe anaphylactic reactions);
- history of bronchial asthma;
- do not use as an analgesic before and during surgery and after manipulations on the coronary vessels;
- severe heart failure;
- nasal polyposis with complete or partial obstruction, angioedema or bronchospasm;
- do not use in patients who have had surgery with a high risk of hemorrhage or incomplete bleeding control and in patients receiving anticoagulants, including low doses of heparin (2500-5000 units every 12 hours);
- hepatic or moderate/severe renal failure (serum creatinine clearance more than 160 µmol/l);
- ketorolac is contraindicated during labor and childbirth because, as a result of its inhibitory effect on prostaglandin synthesis, it can negatively affect fetal circulation and suppress uterine contractions, thereby increasing the risk of uterine bleeding;
- suspected or confirmed cerebrovascular bleeding, bleeding diathesis, including blood coagulation disorders and high risk of bleeding;
- simultaneous treatment with other NSAIDs (including selective cyclooxygenase inhibitors), acetylsalicylic acid, warfarin, pentoxifylline, probenecid or lithium salts;
- hypovolemia, dehydration;
- risk of renal failure due to decreased fluid volume.
Effect of the drug on blood pressure
Ketorolac is not recommended for use in patients with hypertension, since the pharmacological effects of ketorolac include an increase in vascular tone. Particularly dangerous is the combined use of Ketorol with other anti-inflammatory drugs, which, with prolonged use, significantly enhance its pharmacological effect. Despite the fact that the drug is complex, it should not be used solely for the purpose of increasing blood pressure.
"Ketorol" is a drug for pain relief, which is also used for low blood pressure
To reduce the risk of adverse reactions, it is advisable to adhere to the following recommendations:
- if there is a persistent increase in blood pressure, which is accompanied by nausea and vomiting, immediately stop taking the medication;
- if the patient has a pronounced increase in blood pressure, and within 5 hours the drug has not been eliminated from the body, diuretics and antihypertensive drugs should be used;
- Regardless of the chosen dosage form, using Ketolorol for more than 5 days is highly not recommended;
- up to 4 tablets and up to 1 ampoule of ketorolac tromethamine per day are allowed; if pain persists, you should immediately seek medical help;
- It is strictly forbidden for pregnant women, children under 16 years of age and nursing mothers to take the drug.
Potent drugs can cause a large number of adverse chemical reactions. The high pharmacological activity of Ketorol does not allow it to be taken together with glucocorticosteroids, anticoagulants, corticotropin, thrombolytics, and other analgesics. Drinking alcohol along with ketorolac is strictly prohibited, since the drug is incompatible with ethyl alcohol. During treatment, you should exclude all alcohol-containing drops and tinctures.
Ketorol should not be used with alcohol
Mode of application
Ketorol Express in the form of tablets that are dispersed in the oral cavity should be taken only with dry hands.
The tablet should be placed on the tongue, where it will immediately begin to dissolve. Keep it in your mouth for a few seconds until it completely dissolves; if desired, you can wash it down with water.
Taking tablets that are dispersed in the oral cavity do not necessarily require drinking water, do not affect the production of saliva, and allow the drug to be taken by patients with deviations in the act of swallowing due to behavioral or neurological disorders.
To prevent digestive disorders, it is advisable to take the drug during or after a meal (main meal or snack) or with antacids.
Mechanism of action
The main active substance of Ketorol is tromethamine ketorolac, which has a wide range of pharmacological effects. It inhibits cyclooxygenase, a characteristic mediator of inflammation, helping to reduce the concentration of prostaglandins in the body. “Ketorol” is much stronger than conventional analgesics, which is why it is often used for oncology, neuralgia, myalgia, radiculitis, and also in the postoperative period.
The pharmacological effects of the drug are as follows:
- powerful analgesic effect, excellent for pain of various etiologies (muscular, joint, dental, etc.);
- active fight against signs of the inflammatory process (removal of swelling, redness, rapid elimination of itching and burning);
The drug is a non-steroidal analgesic
- the drug has pronounced antipyretic properties aimed at combating local and general hyperthermia;
- mobilization of the body's defenses, accompanied by an increase in vascular tone, which often leads to hypertension;
- "Ketorol" slightly thins the blood, promoting the resorption of blood clots and accelerating blood flow in the body.
The classic drug is produced in the form of an anesthetic solution for muscle injections; its equally popular dosage forms are tablets and capsules. "Ketorol" is much stronger than classical analgesics and NSAIDs ("Ibuprofen", "Analgin", "Paracetamol"), it is recommended to take it in case of severe pain, since the effect of conventional painkillers is sometimes not enough.
With long-term treatment of pain syndrome with Ketorol, persistent hypertension may develop, accompanied by shortness of breath and tachycardia.
Overdose
Symptoms following acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting and epigastric pain, which are usually reversible with supportive treatment. Gastrointestinal bleeding may occur. Rarely, hypertension, acute renal failure, respiratory depression and coma may occur. When NSAIDs are used in therapeutic doses, anaphylactoid reactions have been reported, which may occur after overdose.
Indications for use
Due to its pronounced analgesic effect, the drug is very popular in the field of surgery and oncology. Tromethamine ketorolac, which is part of the drug, copes well with muscle and joint pain, lowers body temperature, and eliminates swelling of soft tissues.
"Ketorol" in its power is close to narcotic analgesics, but is much more modern and safer, has a large number of indications for use and causes much fewer side effects.
Tromethamine ketorolac helps relieve pain in the following conditions:
- menstrual pain of a spastic nature;
- severe toothache;
- pain in connective tissue pathologies (rheumatic lesions, dysplasia, systemic lupus erythematosus);
- in the postoperative period;
- pain of inflammatory origin, accompanied by a prolonged increase in temperature;
- arthralgia, myalgia, neuralgia, radiculitis;
- prolonged aching pain associated with injury (fractures, sprains, dislocations).
For chronic migraines, taking Ketorol is not recommended. To get rid of pain once, one whole tablet is enough. The main positive property of the drug is its speed of action. The effect of taking the medicine occurs within half an hour after using the tablet. The average treatment course, appropriate in case of severe pain or in the postoperative period, is 5–7 days, one capsule three times a day. Low blood pressure is not a contraindication to Ketorol therapy if red blood counts are normal.
"Ketorol" is a non-steroidal analgesic that is used for various types of pain syndrome
Side effects
From the gastrointestinal tract (GIT), including: heartburn, stomatitis, nausea, vomiting, abdominal pain, dyspepsia, constipation/diarrhea, flatulence, feeling of fullness, ulcers in the gastrointestinal tract (in the stomach/duodenum), major bleeding/perforation < > < >Other disorders: renal dysfunction, dizziness, drowsiness, anemia, edema, increased liver enzymes, headaches, hypertension, increased bleeding time, pain at the injection site, itching, purpura, rash, tinnitus, sweating .
Side effects
Solution for intravenous and intramuscular administration, tablets
According to WHO, adverse events are classified as follows: very common (≥10%); often (≥1%, <10%); uncommon (≥0.1%, <1%); rare (≥0.01%, <0.1%); very rare (<0.01%); frequency unknown (frequency cannot be determined from available data).
Allergic reactions: uncommon - anaphylaxis or anaphylactoid reactions (change in facial skin color, skin rash, urticaria, skin itching, tachypnea or dyspnea, swelling of the eyelids, periorbital edema, shortness of breath, difficulty breathing, heaviness in the chest).
Local reactions: often - burning or pain at the site of parenteral administration.
From the side of the central nervous system: very often - headache; often - dizziness, drowsiness, increased sweating; uncommon - tremor, unusual dreams, hallucinations, euphoria, extrapyramidal symptoms, vertigo, paresthesia, depression, insomnia, nervousness, pathological thinking, loss of concentration, hyperkinesis, confusion (stupor), aseptic meningitis (fever, severe headache, convulsions, stiffness of the neck and/or back muscles), psychosis, fainting.
From the skin: often - itching, rash (including maculopapular); uncommon - urticaria, toxic epidermal necrolysis (Lyell's syndrome), malignant exudative erythema (Stevens-Johnson syndrome), exfoliative dermatitis (fever with or without chills, flushing, thickening or peeling of the skin, enlargement and/or tenderness of the tonsils).
From the urinary system: uncommon - hematuria, proteinuria, urinary retention, oliguria, polyuria, frequent urination, acute renal failure, low back pain with or without hematuria and/or azotemia, interstitial nephritis, hyponatremia, hyperkalemia, hemolyticouremic syndrome (hemolytic anemia, renal failure, thrombocytopenia, purpura).
From the digestive system: very often - gastralgia, dyspepsia, nausea; often - diarrhea, constipation, flatulence, feeling of fullness in the stomach, vomiting, stomatitis; uncommon - increased or decreased appetite, anorexia, erosive and ulcerative lesions of the gastrointestinal tract (including with perforation and/or bleeding - abdominal pain, spasm or burning in the epigastric region, blood in the stool or melena, vomiting with blood or type coffee grounds, nausea, heartburn), cholestatic jaundice, hepatitis, hepatomegaly, acute pancreatitis, polydipsia, dry mouth; frequency unknown - exacerbation of ulcerative colitis or Crohn's disease.
From the hematopoietic organs: often - purpura; infrequently - anemia, eosinophilia.
From the respiratory system: infrequently - bronchospasm or shortness of breath, pulmonary edema, rhinitis, laryngeal edema (difficulty breathing).
From the senses: infrequently - taste disturbance, visual impairment (including blurred visual perception), hearing loss, ringing in the ears.
From the cardiovascular system: often - increased blood pressure; infrequently - palpitations, pallor of the skin, fainting, hyperemia; frequency unknown - decreased blood pressure, heart failure, myocardial infarction, stroke.
From the hemostatic system: infrequently - bleeding from a postoperative wound, nosebleeds, rectal bleeding.
Other: often - swelling; uncommon - weight gain, fever, infections, asthenia, increased sweating, swelling of the tongue; frequency unknown - increased concentrations of urea and creatinine in the blood plasma.
Eye drops
Clinical studies of ketorolac in the form of eye drops revealed the following side effects.
On the part of the organ of vision: very often - eye irritation, eye pain, short-term burning sensation, foreign body sensation and blurred vision; often - conjunctival hyperemia, superficial keratitis, iritis, swelling of the eye and/or eyelid, eye infection; uncommon - corneal ulcer, corneal infiltrate, epiphora, dry eyes, iritis, temporary blurred vision; rarely - corneal damage (thinning, erosion, epithelial rupture or perforation).
From the immune system: often - hypersensitivity reactions, urticaria, rash, itching, angioedema, anaphylactic reactions.
From the respiratory system: frequency unknown - bronchospasm, exacerbation of bronchial asthma.
From the nervous system: infrequently - headache.
Systemic reactions: frequency unknown - increased blood pressure, nasal congestion, increased heart rate, as well as prolongation of blood clotting time and increased bleeding of the operated eye with intraocular use of NSAIDs.
From the side of the cornea. The use of local forms of NSAIDs can lead to the development of keratitis. In some sensitive patients, long-term use of NSAIDs may result in destruction of the corneal epithelium, thinning of the cornea, and development of corneal erosion, ulceration, or perforation, which may threaten vision. Patients with signs of corneal impairment should immediately discontinue use of NSAIDs, including ketorolac eye drops, and closely monitor their corneal condition.
Post-marketing experience with NSAIDs suggests that in patients with complications from ocular surgery, corneal denervation, corneal epithelial defects, diabetes mellitus, certain syndromes (eg, dry eye syndrome), rheumatoid arthritis, or repeated ocular surgery within a short period of time may There may be an increased risk of corneal side effects, which may be vision-threatening. Topical NSAIDs should be used with caution in these patients.
Post-marketing experience with NSAIDs also suggests that use of topical NSAIDs more than 1 day before surgery or for more than 14 days after surgery may increase the risk and severity of corneal side effects.
Cross-hypersensitivity to acetylsalicylic acid, phenylacetic acid and other NSAIDs is possible. Therefore, caution should be exercised when using ketorolac in patients who have previously demonstrated hypersensitivity to these drugs.
Gel for external use
Local reactions: itching, urticaria, peeling.
If any adverse reactions occur, you should stop using ketorolac in the form of a gel for external use.
When applying the gel to large areas of the skin, the development of systemic adverse reactions is possible: heartburn, nausea, vomiting, diarrhea, gastralgia, ulceration of the gastrointestinal mucosa, increased activity of liver transaminases; headache, dizziness; fluid retention, hematuria; allergic reactions (anaphylactic shock, skin rash); thrombocytopenia, leukopenia, anemia, agranulocytosis, prolongation of bleeding time.
Note!
Description of the drug Ketorol Express table. disp. 10mg No. 10 on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.
Dosage and recommendations for treatment
In the postoperative period, tablets are usually prescribed, the price of which is affordable. This especially applies to cases where the instructions for use exclude ketorol injections against the background of certain consequences of operations. To relieve pain of any etiology, take one tablet. In case of intense severe pain, repeated use is allowed up to 4 times a day with a break of 4-6 hours. The duration of treatment is 5 days.
Ketorol tablets, the instructions for use emphasize this, should not be taken for any stomach problems. In this case, you need to purchase ketorol injection ampoules. In particular, intramuscular administration is indicated for persistent vomiting or difficulty swallowing. When they ask ketorol injections what they help with, experts often indicate radiculitis. In this case, the pain caused by this pathology can be dealt with quickly. Injections can be repeated with a break of 4 hours.
Ketorol gel is applied in a thin layer to clean and dried skin in areas of pain. Then rub in with soft massage movements. Procedures can be repeated 3-4 times a day until pain is relieved. The break between them is at least 4 hours. The duration of use of the gel is no more than 10 days.
