Ketorolac Baxter (Ketorolac Trometamol)

Ketorolac is an NSAID that provides analgesia by reducing inflammation and prostaglandin production.

• Post‑operative pain: delivers rapid relief of moderate to severe pain after surgery.
• Renal colic: alleviates intense flank pain caused by kidney stones.
• Musculoskeletal pain: reduces pain from injuries or inflammatory conditions of muscles and joints.
• Acute severe pain: offers short‑term control of moderate to severe pain when opioid use is not desired.

• Ketorolac trometamol non‑selectively inhibits cyclooxygenase‑1 and cyclooxygenase‑2 enzymes, blocking the conversion of arachidonic acid to prostaglandins. This reduction in prostaglandin synthesis diminishes peripheral sensitisation of nociceptors and decreases inflammation, resulting in analgesic and antipyretic effects during the acute phase of pain.

Adverse reactions may vary in frequency and severity.

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Headache: transient pain in the head region.
• Dizziness: feeling light‑headed or unsteady.
• Abdominal pain: discomfort in the stomach area.
• Constipation: reduced bowel movements.
• Injection site pain: local soreness after administration.

Serious or Rare Side Effects

• Gastrointestinal bleeding: potentially life‑threatening hemorrhage.
• Renal impairment: reduced kidney function or failure.
• Severe allergic reactions: anaphylaxis, rash, or angioedema.
• Cardiovascular events: myocardial infarction or stroke.
• Hepatic dysfunction: elevated liver enzymes or hepatitis.
• Thrombocytopenia: low platelet count leading to bleeding.

Ketorolac requires careful assessment before and during therapy.

• Renal function: evaluate kidney status; avoid in severe renal impairment.
• Bleeding risk: contraindicated in patients with active ulcers or coagulopathy.
• Pregnancy: use only if benefits outweigh potential fetal risks.
• Concomitant NSAIDs: avoid combined use to reduce gastrointestinal toxicity.
• Duration of therapy: limit to five days or less to minimise adverse events.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Ketorolac can interact with several drug classes, requiring monitoring.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of serious bleeding.
• Other NSAIDs: heightened gastrointestinal toxicity.
• SSRIs/SNRIs: elevated bleeding potential.
• ACE inhibitors/ARBs: may impair renal function.
• Lithium: increased lithium serum concentrations.

Moderate Interactions (Monitor Closely)

• Diuretics: possible reduction in renal clearance.
• Antihypertensives: may blunt blood pressure control.
• Methotrexate: reduced clearance leading to toxicity.
• Corticosteroids: additive risk of gastrointestinal ulceration.
• Cyclosporine: enhanced nephrotoxic effect.