Komorebi (Ketorolac Trometamol)

Komorebi (ketorolac trometamol) is used in ophthalmology to manage inflammation and pain associated with surgical and allergic conditions.

• Post‑operative ocular inflammation: reduces swelling and discomfort after eye surgery.
• Post‑operative ocular pain: provides analgesia following ocular procedures.
• Allergic conjunctivitis: alleviates itching, redness and swelling caused by allergic eye reactions.

• Ketorolac trometamol exerts its effect by non‑selectively inhibiting cyclooxygenase‑1 and cyclooxygenase‑2 enzymes in ocular tissues. This inhibition blocks the conversion of arachidonic acid to prostaglandins, decreasing prostaglandin‑mediated inflammation, vasodilation, and pain signaling within the eye, thereby providing anti‑inflammatory and analgesic actions locally.

Ophthalmic ketorolac may cause local and, rarely, systemic adverse reactions.

Common Side Effects

• Eye irritation or burning sensation.
• Stinging or discomfort upon instillation.
• Transient blurred vision.
• Increased tearing or watery eyes.
• Conjunctival hyperemia (redness).

Serious or Rare Side Effects

• Corneal ulceration or keratitis.
• Severe allergic reactions such as angioedema or Stevens‑Johnson syndrome.
• Significant increase in intra‑ocular pressure.

When using Komorebi, consider the following precautions to ensure safe and effective therapy.

• Hypersensitivity: avoid use in patients with known allergy to ketorolac or other NSAIDs.
• Corneal disease: use with caution in individuals with existing corneal ulcers or keratitis.
• Infection risk: monitor for signs of ocular infection; discontinue if infection develops.
• Concurrent ocular NSAIDs: avoid using other NSAID eye drops simultaneously to reduce additive toxicity.
• Systemic NSAID use: limit concurrent systemic NSAID therapy to lower systemic adverse effect risk.
• Store at room temperature: keep in original container, protect from light and moisture.

Ketorolac ophthalmic can interact with certain systemic and ocular medications.

Major Interactions (Avoid)

• Systemic anticoagulants (e.g., warfarin): increased risk of bleeding.
• Systemic NSAIDs or aspirin: additive risk of systemic adverse effects.
• Other ocular NSAID drops: heightened local toxicity.

Moderate Interactions (Monitor Closely)

• Topical corticosteroids: may delay wound healing when used together.
• Beta‑blocker eye drops: possible alteration of intra‑ocular pressure control.
• Systemic COX‑2 selective inhibitors: monitor for reduced analgesic benefit.