Antipyretic / Analgesic / Anti-Inflammatory
Ketorolac Trometamol (TOROMAX) is a non-narcotic analgesic belonging to the non-steroidal anti-inflammatory drgs (NSAID) class of medicine with analgesic anti-inflammatory and antipyretic properties.
Used for short term management of moderate to severe postoperative pain.
DOSAGE AND ADMINISTRATION
Ketorolac is used intramuscularly, intravenously, or orally as the trometamol salt in the short-term management of moderate to severe postoperative pain. However, it should be noted that because of concerns over the high incidence of reported adverse effects with ketorolac its dosage and maximum duration of use are restricted. The recommended maximum duration for parenteral therapy is 2 days in the UK, and patients should be transferred to oral therapy as soon as possible. In the USA it is recommended that the maximum combined duration of use of parenteral and oral ketorolac should not exceed 5 days.
Ketorolac should not be given to patients already receiving anticoagulants or to those who will require prophylactic anticoagulant therapy, including low-dose heparin. The risk of ketorolac-associated bleeding is also increased by other NSAIDs or aspirin and by pentoxifylline and concomitant use should be avoided. Probenecid increases the half-life and plasma concentrations of ketorolac and the two drugs should not be given together.
Concern over the high incidence of reported adverse effects with ketorolac trometamol has led to its withdrawal in some countries while in others its permitted dosage and maximum duration of treatment have been reduced. Adverse effects reported include gastrointestinal disturbances including gastrointestinal bleeding (especially in the elderly), perforation, and peptic ulceration. Hypersensitivity reactions such as anaphylaxis, rash, bronchospasm, laryngeal oedema, and hypotension have also occurred. Other adverse effects reported include drowsiness, dizziness, headache, mental and sensory changes, psychotic reactions, sweating, dry mouth, thirst, fever, convulsions, myalgia, aseptic meningitis, hypertension, dyspnoea, pulmonary oedema, bradycardia, chest pain, palpitations, fluid retention, increases in blood urea and creatinine, acute renal failure, oedema, hyponatraemia, hyperkalaemia, urinary frequency or retention, nephrotic syndrome, flank pain with or without haematuria, purpura, thrombocytopenia, epistaxis, inhibition of platelet aggregation, increased bleeding time, postoperative wound haemorrhage, haematoma, flushing or pallor, and pancreatitis. Severe skin reactions including Stevens-Johnson syndrome and Lyell's syndrome have been reported. Liver function changes may occur; hepatitis and liver failure have been reported. There may be pain at the site of injection.
Store at temperatures not exceeding 30°C.