Ketorolactrometamol Misom (Ketorolac Trometamol)

Ketorolac trometamol is an ophthalmic NSAID used to manage inflammation and pain associated with ocular surgical procedures.

• Post‑operative ocular inflammation: reduces swelling and redness after cataract, glaucoma or refractive surgery.
• Post‑operative ocular pain: alleviates discomfort and ache following eye operations.
• Laser‑induced ocular irritation: diminishes inflammation and discomfort after laser trabeculoplasty or photocoagulation.

• Ketorolac trometamol exerts its effect by reversibly inhibiting cyclooxygenase‑1 (COX‑1) and cyclooxygenase‑2 (COX‑2) enzymes in ocular tissues. This inhibition blocks the conversion of arachidonic acid to prostaglandins, thereby decreasing prostaglandin‑mediated inflammation, vasodilation and nociceptive signaling, which results in reduced swelling and pain in the eye. The drug is formulated for topical ocular delivery, allowing rapid penetration into the cornea and conjunctiva.

Ketorolac trometamol ophthalmic solution may cause local and systemic adverse reactions, most of which are mild and transient.

Common Side Effects

• Eye irritation or burning sensation: mild discomfort upon instillation.
• Redness of the conjunctiva: transient hyperemia.
• Blurred vision: temporary visual disturbance.
• Tearing: increased lacrimation.
• Foreign body sensation: feeling of grit in the eye.

Serious or Rare Side Effects

• Corneal ulceration: persistent epithelial defect.
• Anterior uveitis: intra‑ocular inflammation.
• Allergic contact dermatitis: eyelid skin reaction.
• Severe ocular pain: worsening despite therapy.
• Vision loss: rare but serious.

When prescribing or dispensing Ketorolac trometamol ophthalmic solution, consider the following precautions to ensure safe use.

• Contraindication: avoid use in patients with known hypersensitivity to ketorolac or other NSAIDs.
• Caution in corneal disorders: use carefully in patients with corneal epithelial defects or keratitis.
• Pregnancy and lactation: safety not established; avoid unless benefits outweigh risks.
• Systemic NSAID use: monitor for additive gastrointestinal or renal effects if patient takes oral NSAIDs.
• Infections: postpone use in active ocular infections until resolved.
• Monitoring: advise patients to report persistent eye pain, visual changes, or signs of ulceration.
• Store at room temperature: keep the bottle in its original packaging, protect from light and moisture, and discard after the indicated period after opening.

Ketorolac trometamol ophthalmic solution can interact with other medications; awareness of these interactions helps prevent adverse outcomes.

Major Interactions (Avoid)

• Systemic NSAIDs: concurrent use may increase risk of gastrointestinal bleeding and renal impairment.
• Anticoagulants (e.g., warfarin): may enhance bleeding tendency, especially in ocular tissues.
• Corticosteroid eye drops: combined use can delay wound healing.

Moderate Interactions (Monitor Closely)

• Beta‑blocker eye drops: may reduce intra‑ocular pressure control when used together.
• Diuretics: monitor renal function if patient is on systemic diuretics.
• Lithium: NSAIDs can increase lithium serum levels; observe for toxicity.