Ketorolac 30mg/ml Inj, 2ml

Ketorolac tromethamine is a nonsteroidal anti-inflammatory drug (NSAID) that exhibits analgesic, anti-inflammatory, and antipyretic activity. Its mechanism of action is thought to be due to its ability to inhibit prostaglandin synthesis by competitively inhibiting the cyclooxygenase (COX-1 and COX-2) enzymes, which are responsible for converting arachidonic acid to prostaglandins.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Note: In rare cases, allergic reactions can be fatal.
Signs of bleeding, including:
+ Vomiting or coughing up blood
+ Vomit that resembles coffee grounds
+ Blood in the urine
+ Black, red, or tarry stools
+ Bleeding from the gums
+ Abnormal vaginal bleeding
+ Unexplained bruises or bruises that increase in size
+ Uncontrollable bleeding
Signs of kidney problems, such as:
+ Inability to urinate
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Signs of high potassium levels, including:
+ Abnormal heartbeat
+ Confusion
+ Weakness, lightheadedness, or dizziness
+ Feeling faint
+ Numbness or tingling
+ Shortness of breath
Signs of high blood pressure, such as:
+ Severe headache or dizziness
+ Fainting
+ Changes in vision
Chest pain or pressure
Weakness on one side of the body
Difficulty speaking or thinking
Changes in balance
Drooping on one side of the face
Blurred vision
Shortness of breath
Sudden weight gain
Swelling in the arms or legs
Feeling extremely tired or weak
Liver problems, which can be life-threatening. If you experience any of the following symptoms, contact your doctor immediately:
+ Dark urine
+ Fatigue
+ Decreased appetite
+ Nausea or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or persist, contact your doctor:

Headache
Stomach pain or heartburn
* Upset stomach

This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following conditions to ensure safe treatment:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction and its symptoms.
If you have experienced nasal polyps, swelling of the mouth, face, lips, tongue, or throat, unusual hoarseness, or breathing difficulties after taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).
Certain health conditions, including:
+ Gastrointestinal (GI) bleeding
+ Kidney disease
+ Ulcer disease
+ Recent heart attack
+ Heart failure (weak heart)
If you are having trouble conceiving or undergoing fertility testing.
Pregnancy or plans to become pregnant: This medication may harm an unborn baby if taken after 20 weeks of pregnancy. If you are between 20 and 30 weeks pregnant, only take this medication under your doctor's guidance. Do not take this medication if you are more than 30 weeks pregnant.

Additionally, inform your doctor about any medications you are taking, including:

Pemetrexed
Pentoxifylline
Probenecid
Salicylate drugs, such as aspirin
Other NSAIDs

This is not an exhaustive list of interacting medications or health conditions. It is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist to ensure safe treatment. Never start, stop, or change the dose of any medication without consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood work and laboratory tests should be conducted as directed by your doctor to monitor your condition.

There is a risk of developing high blood pressure while taking this drug. Your doctor will advise you on how often to have your blood pressure checked. Additionally, you may experience easier bleeding, so it is crucial to be cautious and avoid injuries. To minimize the risk of bleeding, use a soft toothbrush and an electric razor.

If you have asthma, consult your doctor, as you may be more sensitive to this medication. It is also important to discuss alcohol consumption with your doctor before drinking. Furthermore, if you smoke, talk to your doctor about the potential risks.

The use of this medication may increase the risk of heart failure. If you already have heart failure, the risk of heart attack, hospitalization for heart failure, and death may be higher. Your doctor will discuss these risks with you in more detail. Moreover, people who have had a recent heart attack may have a higher risk of heart attack and heart-related death while taking this medication. In fact, studies have shown that individuals taking this medication after a first heart attack were more likely to die within a year compared to those not taking this medication. Your doctor will help you understand these risks and make informed decisions.

Severe skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious reactions, may occur with this medication. These reactions can be life-threatening and may also affect internal organs. Seek immediate medical attention if you experience symptoms such as red, swollen, blistered, or peeling skin; red or irritated eyes; sores in your mouth, throat, nose, eyes, genitals, or skin; fever; chills; body aches; shortness of breath; or swollen glands.

If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects. Nonsteroidal anti-inflammatory drugs (NSAIDs) like this medication may affect ovulation, which can impact fertility. However, this effect is reversible and typically returns to normal once the medication is stopped. Discuss any concerns about fertility with your doctor.

If you are breastfeeding, inform your doctor, as they will need to assess the potential risks to your baby and advise you on the best course of action.

• Other NSAIDs (e.g., ibuprofen, naproxen)
• Aspirin
• Anticoagulants (e.g., warfarin, heparin)
• Pentoxifylline
• Probenecid
• Lithium (high dose)
• Methotrexate (high dose)
• Diuretics (e.g., furosemide, hydrochlorothiazide) in patients with renal impairment

• ACE inhibitors (e.g., lisinopril, enalapril)
• Angiotensin Receptor Blockers (ARBs) (e.g., losartan, valsartan)
• Diuretics (e.g., furosemide, hydrochlorothiazide) - risk of renal impairment
• Cyclosporine
• Tacrolimus
• SSRIs/SNRIs (e.g., fluoxetine, sertraline, venlafaxine) - increased risk of GI bleeding
• Corticosteroids (e.g., prednisone) - increased risk of GI bleeding

• Antidiabetics (e.g., insulin, sulfonylureas) - may alter glucose control
• Digoxin - may increase digoxin levels
• Phenytoin - may increase phenytoin levels
• Quinolone antibiotics (e.g., ciprofloxacin, levofloxacin) - increased risk of seizures
• Pemetrexed - increased risk of myelosuppression, renal, and GI toxicity

• Not available (most interactions are moderate to severe due to NSAID class effects)

• Abdominal pain
• Indigestion (dyspepsia)
• Nausea
• Vomiting
• Black, tarry stools (melena)
• Vomiting blood (hematemesis)
• Unusual bruising or bleeding
• Swelling of hands, feet, or ankles (edema)
• Decreased urine output
• Rash or itching
• Shortness of breath
• Chest pain
• Weakness or numbness on one side of the body
• Slurred speech
• Yellowing of skin or eyes (jaundice)

Contraindicated in the third trimester of pregnancy due to the risk of premature closure of the fetal ductus arteriosus and fetal renal dysfunction. Use in the first and second trimesters should be avoided unless the potential benefit outweighs the potential risk to the fetus.

Ketorolac is excreted in human milk in low concentrations. Due to the potential for serious adverse reactions in breastfed infants (e.g., GI bleeding, renal dysfunction), a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Generally not recommended for children under 16 years of age due to lack of adequate studies and increased risk of adverse effects, particularly renal impairment and GI bleeding. Contraindicated in neonates.

Elderly patients (≥65 years) are at increased risk for serious adverse reactions, including GI bleeding, ulceration, perforation, renal impairment, and cardiovascular events. Lower doses and shorter duration of therapy are recommended. Monitor renal function closely.

• Ketorolac is a potent analgesic and should only be used for short-term (maximum 5 days) management of acute, moderately severe to severe pain.
• It is NOT indicated for chronic pain management or for minor aches and pains.
• The combined duration of parenteral and oral ketorolac should not exceed 5 days.
• Always assess renal function before and during therapy, especially in elderly patients or those with pre-existing renal impairment.
• Avoid concomitant use with other NSAIDs, aspirin, or anticoagulants due to increased risk of bleeding and GI/renal toxicity.
• Not for use in obstetric analgesia or pre-operative use due to effects on platelet aggregation and potential for premature closure of ductus arteriosus.

• Other NSAIDs (e.g., ibuprofen, naproxen, diclofenac)
• Opioid analgesics (e.g., morphine, hydromorphone, oxycodone) for severe pain
• Acetaminophen (for mild to moderate pain)
• Local anesthetics (e.g., lidocaine, bupivacaine)
• Regional nerve blocks

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication.

This medication is accompanied by a Medication Guide, which is a valuable resource that provides important information about your treatment. Please read this guide carefully and review it again whenever you receive a refill of your medication. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, pharmacist, or other healthcare provider for clarification.

In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. When reporting the incident, be prepared to provide details about the medication taken, the amount consumed, and the time it occurred, as this information is crucial for receiving appropriate care.