Nasvical (Ketorolac Trometamol)

Ketorolac trometamol acts as a potent analgesic within the NSAID class, providing relief for acute pain conditions.

• Post‑operative pain: delivers effective analgesia for up to five days after surgery.
• Acute musculoskeletal pain: reduces pain and inflammation following injury or strain.
• Renal colic: alleviates severe flank pain associated with kidney stones.

• Ketorolac trometamol reversibly inhibits cyclooxygenase‑1 and cyclooxygenase‑2 enzymes, blocking the conversion of arachidonic acid to prostaglandins. The reduction in prostaglandin synthesis diminishes peripheral sensitisation, inflammation, and nociceptive signalling, resulting in analgesic and anti‑inflammatory effects.

Ketorolac trometamol may cause a range of adverse reactions, most of which are dose‑related and reversible.

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Headache: transient cranial discomfort.
• Dizziness: occasional light‑headedness.
• Injection‑site pain: local tenderness or erythema.
• Gastrointestinal upset: dyspepsia or abdominal discomfort.
• Elevated blood pressure: transient rise in systolic or diastolic values.

Serious or Rare Side Effects

• Gastrointestinal bleeding: potentially life‑threatening hemorrhage.
• Renal impairment: acute kidney injury, especially with prolonged use.
• Severe allergic reactions: anaphylaxis, angioedema, or urticaria.
• Cardiovascular thrombotic events: myocardial infarction or stroke.
• Stevens‑Johnson syndrome: severe skin and mucosal reactions.
• Hepatic dysfunction: elevated liver enzymes or hepatitis.

Ketorolac trometamol requires careful assessment before use to minimise risk of serious complications.

• Assess renal function: avoid in patients with severe renal impairment.
• Monitor bleeding risk: contraindicated in active peptic ulcer disease or recent hemorrhage.
• Avoid in pregnancy: only if benefits outweigh potential fetal risks.
• Use with caution in the elderly: increased susceptibility to adverse events.
• Concomitant NSAIDs: increase risk of gastrointestinal and renal toxicity.
• Store below 25°C: keep in original container, protect from moisture and light.

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

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): heightened risk of serious bleeding.
• Other NSAIDs or aspirin: additive gastrointestinal toxicity.
• Lithium: increased lithium serum concentrations.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or diuretics: may reduce renal perfusion.
• Selective serotonin reuptake inhibitors (SSRIs): modestly increase bleeding tendency.
• Oral contraceptives: potential reduction in contraceptive effectiveness.