Ketanov (Ketorolac Trometamol)

Ketorolac is a nonsteroidal anti-inflammatory drug used for short‑term pain management.

• Post‑operative pain: provides effective analgesia to reduce the need for opioid medication.
• Acute musculoskeletal pain: relieves pain and inflammation following sprains, strains, or soft‑tissue injuries.
• Dental pain: controls moderate to severe pain after dental extractions or oral surgery.

• Ketorolac inhibits cyclooxygenase (COX‑1 and COX‑2) enzymes, which blocks the conversion of arachidonic acid to prostaglandins. By reducing prostaglandin synthesis, it diminishes inflammation, nociceptive signaling, and fever, resulting in analgesic and anti‑inflammatory effects without directly acting on opioid receptors.

Ketorolac may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Headache: transient pain in the head region.
• Dizziness: sensation of light‑headedness or unsteadiness.
• Dyspepsia: discomfort or burning in the upper abdomen.
• Diarrhea: loose, frequent stools.
• Edema: mild swelling of the extremities.

Serious or Rare Side Effects

• Gastrointestinal bleeding: potentially life‑threatening hemorrhage.
• Renal impairment: reduced kidney function or failure.
• Cardiovascular events: increased risk of heart attack or stroke.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Anaphylaxis: acute, potentially fatal allergic response.
• Hepatotoxicity: liver enzyme elevations or injury.

Before prescribing ketorolac, clinicians should evaluate patient‑specific risk factors and monitor for adverse events.

• Assess renal function: avoid use in patients with severe renal impairment or those requiring dialysis.
• Evaluate gastrointestinal risk: use cautiously in individuals with a history of ulcers, bleeding, or chronic NSAID use.
• Monitor cardiovascular status: consider risk of thrombotic events in patients with existing heart disease.
• Check for hypersensitivity: discontinue immediately if signs of allergic reaction appear.
• Review concomitant medications: avoid combining with other NSAIDs, anticoagulants, or corticosteroids without justification.
• Store at ambient temperature: keep below 25 °C, retain in the original packaging, and protect from moisture.

Ketorolac can interact with several drug classes, altering efficacy or safety.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin, direct oral anticoagulants): increased risk of serious bleeding.
• Other NSAIDs or aspirin: heightened gastrointestinal toxicity.
• Corticosteroids: synergistic effect on ulcer formation.
• Lithium: ketorolac may raise serum lithium levels, risking toxicity.

Moderate Interactions (Monitor Closely)

• Antihypertensives (ACE inhibitors, ARBs, diuretics): possible reduction in antihypertensive effect and renal function.
• Methotrexate: decreased clearance leading to toxicity.
• SSRIs or SNRIs: modest increase in bleeding risk.
• Diuretics: potential for reduced renal perfusion when combined with ketorolac.