Ketorol: instruction on the use of injections, tablets

Content

  • 1Ketorol - instructions, use, contraindications
    • 1.1pharmachologic effect
    • 1.2Indications for use
    • 1.3Instructions for use Ketorol
    • 1.4Side effects
    • 1.5Contraindications to application Ketorol
    • 1.6Additional Information
  • 2Ketorol nyxes: instructions for use
    • 2.1Form of issue and composition
    • 2.2pharmachologic effect
    • 2.3Indications for use
    • 2.4Contraindications for use
    • 2.5Dosing and Administration
    • 2.6Side effects
    • 2.7special instructions
    • 2.8Overdose
    • 2.9Analogues of injections Ketorol
    • 2.10Terms and conditions of storage
    • 2.11Ketorol shots price
  • 3What helps pills Ketorol
    • 3.1Form of issue
    • 3.2Composition
    • 3.3pharmachologic effect
    • 3.4Indications for use
    • 3.5Ketorol tablets: what helps the tablet form of the drug?
    • 3.6What helps the medicine in pricks?
    • 3.7Indications for the use of Ketorol: what is the gel used for?
    • 3.8Ketorol: instructions for use
    • 3.9Contraindications
    • 3.10Side effects
    • 3.11How much are the tablets, gel and ampoules of Ketorol?
    • 3.12Patient's opinions
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  • 4Ketorol: instructions for use - Yandex. Health
  • 5Ketorol - instructions for use, counterparts, price, reviews
    • 5.1Active substance
    • 5.2Form of issue and composition
    • 5.3Indications for use
    • 5.4Contraindications
    • 5.5Instructions for use Ketorol (method and dosage)
    • 5.6Side effects
    • 5.7Overdose
    • 5.8Analogues
    • 5.9pharmachologic effect
    • 5.10special instructions
    • 5.11At pregnancy and thoracal feeding
    • 5.12In childhood
    • 5.13In old age
    • 5.14In case of violations of kidney function
    • 5.15With violations of liver function
    • 5.16Drug Interactions
    • 5.17Conditions of leave from pharmacies
    • 5.18Terms and conditions of storage
    • 5.19Price in pharmacies

Ketorol - instructions, use, contraindications

Ketorol is an analgesic drug with anti-inflammatory and antipyretic effect.

pharmachologic effect

The active substance Ketorol is ketorolac, which, suppressing the activity of the enzyme cyclooxygenase, promotes inhibition of biosynthesis of prostaglandins, which are modulators of inflammation, thermoregulation and pain sensitivity.

Analgesic action Ketorol pricks can be observed after half an hour after the injection, and the maximum effect - after 1-2 hours.

The therapeutic effect of Ketorol persists for 4-6 hours.

Indications for use

Assign Ketorol instruction recommends with a moderate or severe pain syndrome: pain in the muscles and back, pain in injuries in joints, sprains, dislocations, postoperative pain, neuralgia, oncological diseases, radiculitis, toothache, migraine, burns and other

Instructions for use Ketorol

Ketorol, the use of which is appropriate only in acute pain syndrome, and not for the treatment of chronic pain, is available in the form of tablets and a solution for intramuscular injection.

Depending on the severity of Ketorol's pain syndrome, tablets can be given once or repeatedly.

Once it is usually recommended to take 10 mg (1 table), and repeatedly - 10 mg, but no more than 4 times a day. Take Ketorol tablets for longer than 5 days is contraindicated.

The injection solution should be administered intramuscularly.

[attention type = red]

To patients younger than 65 years of age, Ketorol injections are prescribed in a dose of 10-30 mg once or the same dose - every 4-6 hours, with the maximum daily dose should not exceed 90 mg.

[/ attention]

Patients older than 65 years of age are given ketorol as described above, with the only difference being that the maximum single dose should be 15 mg, and the maximum daily dose should be 60 mg. Ketorol nyxes can be applied no longer than 5 days.

When switching from intramuscular to oral administration of Ketorol, total daily doses of the drug: on the day of the transition - 30 mg, for patients over 65 years - 60 mg, for patients younger than 65 years - 90 mg.

Side effects

Ketorol tablets and injections can provoke in patients such undesirable reactions as:

  • diarrhea, stomach pain, vomiting, constipation, flatulence, stomatitis, nausea, heartburn;
  • back pain, acute renal failure, frequent urination, nephritis (inflammation of the kidney), a decrease or increase in the volume of urine;
  • bronchospasm, laryngeal edema, rhinitis;
  • headache, drowsiness, dizziness, hyperactivity, depression, ringing in the ears, hearing loss, blurred vision.
  • increased blood pressure, fainting, pulmonary edema;
  • leukopenia (increase of leukocytes in the blood), eosinophilia (increase in the number of eosinophils), anemia (decrease in the number of erythrocytes or hemoglobin);
  • rectal, nasal, from postoperative bleeding wounds;
  • purpura, skin rash, urticaria, Lyell's syndrome (allergic dermatitis as a reaction to medicinal drugs), Stevens-Johnson syndrome (the occurrence of vesicles on the skin and mucous membrane of various bodies);
  • itching, hives, discoloration, skin rash, swelling of the eyelids, shortness of breath, wheezing, heaviness in the chest;
  • weight gain, swelling of the feet, fingers, ankles, legs, face, tongue, excessive sweating, fever;
  • pain or burning at the site of injection Ketorol.

Contraindications to application Ketorol

According to the instructions, Ketorol is not used to treat chronic pain syndrome. Contraindicated in the use of Ketorol when:

  • bronchospasm (narrowing of the bronchi as a result of muscle contraction);
  • "Aspirin" asthma (attacks of suffocation, associated with the intake of salicylates);
  • hypovolemia (decrease in blood volume);
  • angioedema (limited deep swelling of the mucous membranes or subcutaneous tissue and skin);
  • dehydration (dehydration);
  • peptic ulcers (expression of the mucous membrane of the esophagus as a result of the action of gastric juice on one of its segments);
  • erosive and ulcerative lesions of the digestive tract in the phase of exacerbation;
  • hypocoagulation (low blood coagulation);
  • hemorrhagic diathesis (diseases of the blood system, which are characterized by a tendency to increased bleeding);
  • hemorrhagic stroke (cerebral hemorrhage caused by rupture of blood vessels);
  • hepatic or renal insufficiency;
  • simultaneous administration with other anti-inflammatory non-steroid drugs;
  • violation of the blood;
  • high risk of bleeding;
  • hypersensitivity to ketorolac or other non-steroidal anti-inflammatory drugs.

Ketorol, the use of which must be agreed with the attending physician, is not prescribed for pregnant and lactating women, as well as children and adolescents under 16 years of age.

With caution apply Ketorol instruction recommends for cholecystitis (inflammation of the gallbladder), hypertension, chronic heart failure, bronchial asthma, impaired renal function, sepsis (ingestion of the causative agents of the infection), active hepatitis, polyps (tissue outgrowths) of the mucous membrane of the nasopharynx and nose, systemic lupus erythematosus (connective disease tissue).

Additional Information

Store Ketorol instruction recommends in a dark place where the air temperature does not rise above 250C. Shelf life Ketorol tablets and solution for injection - 3 years.

A source: http://www.neboleem.net/ketorol.php

Ketorol nyxes: instructions for use

Solution for parenteral administration Ketorol is a non-steroidal anti-inflammatory drug of the clinical and pharmacological group. It is used to reduce the severity of pain syndrome with various inflammatory pathologies.

Form of issue and composition

Ketorol is a clear, colorless liquid that should not contain visible impurities or inclusions.

The main active substance of the drug is ketorolac, its content in 1 ml of the solution is 30 mg.

It also includes auxiliary components, which include:

  • Ethanol.
  • Disodium edetat.
  • Sodium hydroxide.
  • Sodium chloride.
  • Propylene glycol.
  • Oksinol.

The solution for parenteral administration of Ketorol is contained in dark glass ampoules of 1 ml volume, they are packaged in contour acheikova packing in an amount of 10 pieces. The cardboard pack contains one contour mesh package and instructions for the use of the preparation.

pharmachologic effect

The mechanism of analgesic effect of the active substance of the solution for Ketorol injection lies in nonselective blocking activity of the enzyme cycloxygenase (COX 1 and 2), which catalyzes the process of chemical transformation of arachidonic acid into prostaglandins. These compounds are mediators of the inflammatory reaction, they are produced by the cells of the immune system during tissue damage and cause a number of biological effects. The development of pain sensations in this case is associated with the immediate irritation of the prostaglandins of sensitive nerve endings. By reducing the concentration of prostaglandins in the inflammatory reaction, Ketorol's injection solution reduces the severity of the pain syndrome. Also, to a lesser extent, it reduces the severity of hyperemia and edema, and also reduces body temperature as it rises. The drug reduces the level of prostaglandins of the upper gastrointestinal tract, which perform a protective function and prostaglandins providing the process of aggregation (gluing) of platelets during formation a thrombus.

After the parenteral injection of Ketorol injection, the active ingredient quickly accumulates in the tissues, and is evenly distributed in them. Metabolized ketorolac in hepatocytes (liver cells) with the formation of inactive decay products, which are excreted from the body with urine.

Indications for use

Application of the solution for parenteral administration Ketorol is indicated for symptomatic and pathogenetic treatment of inflammatory pathology, accompanied by the development of pain syndrome:

  • Inflammation of joints (arthritis) due to infectious, autoimmune process, as well as degenerative-dystrophic destruction of articular cartilage (arthrosis).
  • Pain in the muscles (myalgia) and peripheral nerves (neuralgia), which are caused by aseptic inflammation.
  • Post-traumatic and post-operative pain of moderate severity.
  • Rheumatic pathology associated with the production of antibodies to the body's own tissues and the development of specific autoimmune inflammation.

It can also be used for oncological pathology, accompanied by pain syndrome of medium intensity.

Contraindications for use

Introduction of injection Ketorol is contraindicated in a number of pathological and physiological conditions of the body, which include:

  • Individual intolerance to ketorolac or auxiliary components of the drug.
  • The presence of "aspirin asthma which is accompanied by the development of bronchospasm (narrowing of the bronchi due to the increase tonus smooth muscle of their walls) in response to the ingestion of non-steroidal anti-inflammatory connections.
  • Pronounced hepatic or renal insufficiency.
  • Dehydration (dehydration of the body) and hypovolemia (decrease in the volume of circulating blood), regardless of the cause of their occurrence.
  • Decreased coagulation (hemophilia).
  • Confirmed hemorrhagic stroke (cerebral hemorrhage) or suspicion of it.
  • Simultaneous reception of other drugs group of non-steroidal anti-inflammatory drugs.
  • Pronounced allergic reactions, in particular bronchospasm and angioedema, Quincke (pronounced edema tissues of the face or genital area, which develops due to increased vascular permeability walls).
  • Pathological processes, accompanied by a violation of hematopoiesis.
  • Hemorrhagic diathesis is a disease of thrombocytes, which leads to increased bleeding from not large vessels.
  • Increased risk of bleeding, including those associated with surgical intervention.
  • Pregnancy at any time of the current, childbirth and breastfeeding.
  • Children under 16 years.
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The use of the drug is limited before performing surgical procedures due to increased risk of bleeding during their implementation. Before starting the solution for parenteral administration, it should be ensured that there are no contraindications.

Dosing and Administration

Solution for parenteral administration Ketorol is administered intramuscularly in a minimum therapeutically effective dose, which depends on the severity of the pain syndrome. A single dose can vary from 10 to 30 mg.

Persons with impaired functional activity of the kidneys of mild and moderate severity, as well as people over 65 years of age, the dose of the drug is reduced to 10-15 mg.

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Several injections of the drug in this dosage are allowed with an interval of 4-6 hours. At the same time, the maximum daily dose should not exceed 90 mg, for people with impaired renal function and elderly people over 65, 60 mg.

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The duration of the course of parenteral injection for injections should not exceed 5 days.

Side effects

The initiation of treatment with a solution for parenteral administration can lead to the development of undesirable reactions from various organs and systems:

  • Digestive system - gastralgia (pain in the stomach), diarrhea, nausea, vomiting, flatulence (bloating), feeling of overcrowded stomach, stomatitis (inflammation of the mucous membrane of the mouth), the formation of erosions and ulcers of the stomach or duodenum, the development of gastrointestinal bleeding, hepatitis (inflammation of the liver caused by damage to hepatocytes), cholestatic jaundice, provoked by a violation of the outflow of bile from gallbladder.
  • Nervous system - periodic dizziness, headache, drowsiness, very rarely develops aseptic meningitis (reactive inflammation of the meninges), increased activity of the nervous system, hallucinations, depression, psychosis.
  • Sensory organs - noise or ringing in the ears, decreased vision (blurring of visual perception).
  • The system of breathing - bronchospasm, dyspnea, laryngeal edema, rhinitis (inflammation of the nasal mucosa).
  • Urinary system - acute renal failure (very rarely), hematuria (the appearance of blood in the urine), increased frequency of urination with a change in volume (increase or decrease) of excreted urine.
  • Red bone marrow and blood system - anemia (anemia), eosinophilia (increase in the number of eosinophils in the blood), leukopenia (decrease in the number of leukocytes), a decrease in blood clotting.
  • Skin - development of small-scale rash with itching, exfoliative dermatitis (skin tightening, development of peeling on a background of increased body temperature with or without fever), Stevens-Johnson syndrome, Lyell (severe skin damage with partial necrosis).

The development of side effects is the basis for the abolition of the use of the solution for parenteral administration of Ketorol.

special instructions

Before starting the application of Ketorol injection, it is important to read the instructions carefully and pay attention to such specific instructions:

  • The effect on platelet aggregation (gluing) is significantly reduced 24-48 hours after drug withdrawal.
  • The use of a solution for parenteral administration of Ketorol is excluded as an analgesic in obstetric practice.
  • Reducing the volume of circulating blood (hypovolemia) significantly increases the risk of side effects from the kidneys against the background of the drug.
  • Excludes joint use of the drug with other non-steroidal anti-inflammatory drugs.
  • Solution for injection Ketorol after its introduction can interact with drugs of other clinico-pharmacological groups, therefore, if used, this should be doctor.
  • In connection with the possible development of side effects from the central nervous system, it is not recommended to perform work, associated with the need for increased concentration and speed of psychomotor reactions during application preparation.

In the pharmacy network, the solution for parenteral administration of Ketorol is dispensed by prescription. You can not start its independent use or use it on the recommendation of third parties.

Overdose

Exceeding the recommended therapeutic dose of the solution for parenteral administration of Ketorol is accompanied by pain in the stomach, nausea, vomiting, the development of erosions of the stomach, kidney damage and metabolic alkalosis (alkalinization blood). Treatment of an overdose consists in conducting symptomatic therapy, since with the help of hemodialysis (hardware purification of blood) the concentration of the active substance of the drug in the body is reduced practically is impossible.

Analogues of injections Ketorol

Structural analogs for the parenteral Ketorol solution are preparations of Ketanov, Ketorolac. They contain the same active substance and have a similar therapeutic effect.

Terms and conditions of storage

The shelf life of the Ketorol injection solution is 3 years. The drug should be stored in a dark place inaccessible to children at an air temperature of not more than + 25ºC.

Ketorol shots price

The average cost of a solution for Ketorol injections in pharmacies in Moscow varies between 134-149 rubles.

A source: http://bezboleznej.ru/ketorol-ukoly

What helps pills Ketorol

Ketorol tablets, what helps this analgesic drug with anti-inflammatory and antipyretic effects? The drug is designed to relieve pain with various ailments.

Form of issue

  • Produced in the form of tablets in p / o 10 mg. Ketorol tablets (INN-Ketorolac) are biconvex, round in shape, covered with a green coat (the nucleus is white or close to white). On one side there is an impression in the form of the letter "S".
  • A solution for intravenous and intravenous administration of 30 mg / ml is produced. Ketorol in injections is available in ampoules of 1 ml, each of which has a fracture point and a ring at the top.
  • Use also 2% gel for external use, tubes 30 g. Ketorol gel is a homogeneous, characteristic smelling, transparent (or semitransparent) substance.

Composition

Tablet composition: ketorolac (10 mg / tab), MCC, lactose, corn starch, colloidal silicon dioxide, Mg stearate, carboxymethyl starch Na (type A).

The film sheath includes: hypromellose, propylene glycol (additive E1520), titanium dioxide; dyes brilliant blue (22%) and quinoline yellow (78%) - olive green.

Composition of the solution: ketorolac (30 mg in milliliters), octoxynol, EDTA, Na chloride, ethanol, propylene glycol (additive E1520), Na hydroxide, water d / u.

The gel composition: ketorolac (20 mg in grams of gel), propylene glycol (additive E1520), dimethylsulfoxide, carbomer 974P, methyl- and propyl parahydroxybenzoate Na, tromethamine (trometamol), "Drimon Inde" flavor, ethanol, glycerol, purified water.

pharmachologic effect

The active substance of Ketorol tablets (from which the remedy for pains of various organs helps) is ketorolac, which, suppressing the activity of the enzyme cyclooxygenase, promotes inhibition of biosynthesis of prostaglandins, which are modulators of inflammation, thermoregulation and pain sensitivity. Analgesic action Ketorol pricks can be observed after half an hour after the injection, and the maximum effect - after 1-2 hours. The therapeutic effect of Ketorol persists for 4-6 hours.

Indications for use

Ketorol tablets: what helps the tablet form of the drug?

The medicine helps to reduce moderate / severe pain and inflammation, but does not affect the progression of the disease.

Tablets are effective in case of toothache, headache, pain that occurs with menstruation, after trauma, in the postoperative and postpartum periods, on the background of cancer, with damage to the peripheral nerves, with radiculopathy, arthralgia, myalgia, sprains, dislocations, rheumatic diseases.

What helps the medicine in pricks?

Ketorol in ampoules, like the tablet form of the drug, is used to relieve pain of medium and strong intensity.

Parenteral administration of the drug is preferred in situations where it is necessary to quickly relieve the pain, and Also, if the patient can not take it inside (for example, with peptic ulcer or because of vomiting reflex).

Indications for the use of Ketorol: what is the gel used for?

Local application of the gel helps to reduce pain and inflammation with:

  • trauma (inflammation and bruises of soft tissues, including after trauma;
  • Bursitis, synovitis, damage to ligaments, epicondylitis, tendonitis);
  • myalgia;
  • arthralgia;
  • radiculitis;
  • neuralgia;
  • rheumatic diseases.

Ketorol: instructions for use

Ketorol, the use of which is appropriate only in acute pain syndrome, and not for the treatment of chronic pain, is available in the form of tablets and a solution for intramuscular injection.

Depending on the severity of Ketorol's pain syndrome, tablets can be given once or repeatedly.

Once it is usually recommended to take 10 mg (1 table), and repeatedly - 10 mg, but no more than 4 times a day. Take Ketorol tablets for longer than 5 days is contraindicated.

The injection solution should be administered intramuscularly.

[attention type = red]

To patients younger than 65 years of age, Ketorol injections are prescribed in a dose of 10-30 mg once or the same dose - every 4-6 hours, with the maximum daily dose should not exceed 90 mg.

[/ attention]

Patients over 65 years of age are injected according to the scheme described above, with the only difference being that the maximum single dose should correspond to 15 mg, and the maximum daily dose should be 60 mg. Ketorol nyxes can be applied no longer than 5 days.

When switching from intramuscular to oral administration of Ketorol, total daily doses of the drug: on the day of the transition - 30 mg, for patients over 65 years - 60 mg, for patients younger than 65 years - 90 mg.

Contraindications

Prohibitions for parenteral administration and administration of Ketorol by mouth:

  • hypersensitivity to the components of the solution / tablets;
  • complete or partial combination of clinical manifestations of aspirin bronchial asthma (intolerance of NSAIDs, asthma attacks, polypsic rhinosinusitis);
  • the presence of erosion and ulcerative defects on the mucosa of the upper gastrointestinal tract;
  • bleeding in the active phase (gastrointestinal, cerebrovascular or other);
  • aggravated inflammatory bowel disease;
  • hemophilia and other pathologies of the hemostatic system;
  • terminal stage of development of heart failure (decompensated heart failure);
  • functional disorders or active course of liver disease;
  • confirmed hyperkalemia;
  • postoperative period after CABG;
  • renal failure, in which the creatinine concentration does not exceed 30 ml / min, progressive kidney pathology;
  • pregnancy, childbirth, lactation;
  • age to 16 years.
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Side effects

Ketorol tablets and injections can provoke in patients such undesirable reactions as:

  • diarrhea, stomach pain, vomiting, constipation, flatulence, stomatitis, nausea, heartburn;
  • back pain, acute renal failure, frequent urination, nephritis (inflammation of the kidney), a decrease or increase in the volume of urine;
  • bronchospasm, laryngeal edema, rhinitis;
  • headache, drowsiness, dizziness, hyperactivity, depression, ringing in the ears, hearing loss, blurred vision.
  • increased blood pressure, fainting, pulmonary edema;
  • leukopenia (increase of leukocytes in the blood), eosinophilia (increase in the number of eosinophils), anemia (decrease in the number of erythrocytes or hemoglobin);
  • rectal, nasal, from postoperative bleeding wounds;
  • purpura, skin rash, urticaria, Lyell's syndrome (allergic dermatitis as a reaction to medicinal drugs), Stevens-Johnson syndrome (the occurrence of vesicles on the skin and mucous membrane of various bodies);
  • itching, hives, discoloration, skin rash, swelling of the eyelids, shortness of breath, wheezing, heaviness in the chest;
  • weight gain, swelling of the feet, fingers, ankles, legs, face, tongue, excessive sweating, fever;
  • pain or burning at the site of injection Ketorol.

How much are the tablets, gel and ampoules of Ketorol?

In Russia, the average price of Ketorol in tablets is 50 rubles, the price of Ketorol in ampoules is 150 rubles, the cost of ointment (gel) is 230 rubles.

Patient's opinions

Reviews of Ketorol in tablets, as well as reviews of injections and gels in 95-98% of cases are positive. Ketorol from toothache, from pain in the back and muscles, from the headache helps already for half an hour, and its effect persists to six hours.

Most patients note that when the drug is administered according to the instructions, side effects are extremely rare. Sometimes the disadvantages of Ketorol are a large number of contraindications and the impossibility of prolonged use.

To resort to the remedy "Ketorol" from which he helps us, had not so long ago: the husband fell so it was unfortunate that I had to call for an ambulance, because because of a painful shock he was close to a faint state.

The ambulance gave him an injection of pain medication and recommended taking the pill as the pain re-emerged. And again, "Ketorol" was very effective, it perfectly removed the pain and acted up to 8 hours.

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In general, now we always keep Ketorol near at hand, but we hope that we will not need to apply it.

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I did not have any side effects, although I had to take the pill within 3 or 4 days (I do not remember anymore), because the pain would be very strong, especially on the first day after the operation.

I was happy with the fact that Ketorol was acting quickly, even he took off a strong pain 15-20 minutes after taking one pill and there was enough pain relief for 4-6 hours the first day of admission, for 8 hours on the second day of admission and then I already managed one tablet a day in the morning and one pill at night, the action of the medicine was enough for 12 hours.

A source: http://remedy.ucoz.ru/index/ketorol_ot_chego_pomogaet/0-246

Ketorol: instructions for use - Yandex. Health

Film-coated tabletsgreen, round, biconcave, embossed with the letter "S" on one side; the cross-sectional view is a shell of green color and a core of white or almost white color.

1 tab.
ketorolac tromethamine (ketorolac trometamol) 10 mg

Excipients: microcrystalline cellulose - 121 mg, lactose - 15 mg, corn starch - 20 mg, silicon dioxide colloid - 4 mg, magnesium stearate - 2 mg, sodium carboxymethyl starch (type A) - 15 mg.

Composition of the film shell:hypromellose - 2.6 mg, propylene glycol 0.97 mg, titanium dioxide 0.33 mg, olive green (dye quinoline yellow 78%, dye blue 22%) 0.1 mg.

10 pieces. - blisters (2) - packs of cardboard.

NSAIDs, has a pronounced analgesic effect, has an anti-inflammatory and moderate antipyretic effect.

The mechanism of action is associated with nonselective inhibition of COX activity (COX-1 and COX-2) catalyzing the formation of prostaglandins from arachidonic acid, which play an important role in the pathogenesis of pain, inflammation and fever.

Ketorolac is a racemic mixture of [-] S- and [+] R-enantiomers, with an analgesic effect due to [-] S-form. By the strength of the analgesic effect comparable to morphine, it significantly exceeds other NSAIDs.

The drug does not affect opioid receptors, does not depress respiration, does not cause drug dependence, does not have sedative and anxiolytic effects.

After ingestion, the analgesic effect develops after 1 hour.

Suction

When ingested ketorolac is absorbed well and quickly from the digestive tract. Bioavailability of ketorolac is 80-100%, Cmax after oral administration in a dose of 10 mg is 0.82-1.46 μg / ml, Tmax is 10-78 minutes. Fat-rich food reduces the Cmax drug in the blood and delays its achievement by an hour.

Distribution

Binding to plasma proteins composes 99%, Vd - 0.15-0.33 l / kg. The time to achieve Css when taken orally at a dose of 10 mg 4 times / day is 24 hours, Css - 0.39-0.79 μg / ml.

Excreted in breast milk: when taking ketorolac at a dose of 10 mg Cmax in breast milk is achieved 2 hours after taking the first dose and is 7.3 ng / ml, 2 hours after the second dose of ketorolac (with the drug 4 times / day) - 7.9 ng / l.

Metabolism

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More than 50% of the administered dose is metabolized in the liver with the formation of pharmacologically inactive metabolites. The main metabolites are glucuronides and p-hydroxycetorolac.

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Excretion

It is excreted mainly by the kidneys - 91%, through the intestine - 6%, glucuronides are excreted in the urine. It is not excreted by hemodialysis.

T1 / 2 in patients with normal renal function averaged 5.3 hours (2.4-9 hours after oral administration at a dose of 10 mg). When administered orally at a dose of 10 mg, the total clearance is 0.025 l / h / kg.

Pharmacokinetics in specific patient groups

T1 / 2 increases in elderly patients and is shortened in young people.

Disturbance of liver function does not affect T1 / 2.

In patients with renal insufficiency, Vd of the drug may increase by 2 times, and Vd of its R-enantiomer by 20%.

In patients with impaired renal function with a creatinine concentration in the plasma of 19-50 mg / l (168-442 μmol / l), T1 / 2 is 10.3-10.8 hours, with severe renal failure - more than 13.6 hours.

In patients with renal failure (at a plasma creatinine concentration of 19-50 mg / l), the total clearance is 0.016 l / h / kg.

Pain syndrome of strong and moderate severity:

- trauma;

- toothache;

- Pain in the postpartum and postoperative period;

- oncological diseases;

- myalgia;

- Arthralgia;

- Neuralgia, sciatica;

- dislocations, sprains;

- rheumatic diseases.

It is intended for symptomatic therapy, reducing the intensity of pain and inflammation at the time of application, the progression of the disease is not affected.

Take inside a single dose of 10 mg.

Whensevere pain syndromethe drug is taken repeatedly for 10 mg up to 4 times / day, depending on the severity of the pain.

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The maximum daily dose is 40 mg. The minimum effective dose should be used.

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When administered orally, the duration of treatment should not exceed 5 days.

When switching from parenteral administration of the drug to its administration, the total daily dose of both dosage forms on the day of transfer should not exceed 90 mg forpatients aged 16 to 65 yearsand 60 mg forpatients older than 65 yearsor withimpaired renal function. In this case, the dose of the drug in tablets on the day of transition should not exceed 30 mg.

Determination of the frequency of side effects: often (1-10%), sometimes (0.1-1%), rarely (0.01-0.1%), very rarely (less than 0.01%), including individual reports.

From the digestive system:Often (especially in elderly patients over the age of 65 who have a history of erosive and ulcerative gastrointestinal lesions) - gastralgia, diarrhea; sometimes - stomatitis, flatulence, constipation, vomiting, sensation of stomach overflow; rarely - nausea, erosive and ulcerative lesions of the gastrointestinal tract (including with perforation and / or bleeding - abdominal pain, spasm or burning in the epigastric region, melena, vomiting like "coffee grounds nausea, heartburn and others), cholestatic jaundice, hepatitis, hepatomegaly, acute pancreatitis.

From the urinary system:rarely - acute renal failure, back pain with or without hematuria and / or azotemia, haemolytic-uremic syndrome (hemolytic anemia, kidney failure, thrombocytopenia, purpura), frequent urination, increased or decreased urine volume, nephritis, edema of the kidney genesis.

From the sense organs:rarely - hearing loss, ringing in the ears, impaired vision (including blurred vision).

From the respiratory system:rarely - bronchospasm, dyspnea, rhinitis, laryngeal edema.

From the nervous system:often - headache, dizziness, drowsiness; rarely - aseptic meningitis (fever, severe headache, seizures, stiff neck and / or back muscles), hyperactivity (mood changes, anxiety), hallucinations, depression, psychosis.

From the cardiovascular system:sometimes - an increase in blood pressure; rarely - pulmonary edema, fainting.

On the part of the hematopoiesis system:rarely - anemia, eosinophilia, leukopenia.

From the side of hemostasis:rarely bleeding from a postoperative wound, epistaxis, rectal bleeding.

From the skin:sometimes - a skin rash (including a maculopapular rash), purpura; rarely - exfoliative dermatitis (fever with chills or without, redness, densification or flaking of the skin, swelling and / or tenderness of the tonsils), urticaria, Stevens-Johnson syndrome, Lyell's syndrome.

Allergic reactions:rarely anaphylaxis or anaphylactoid reactions (skin discoloration, skin rash, hives, itchy skin, tachypnea or dyspnoea, edema of the eyelids, periorbital edema, shortness of breath, shortness of breath, heaviness in the chest, wheezing).

Other:often - swelling (face, legs, ankles, fingers, feet, weight gain); sometimes - increased sweating; rarely - swelling of the tongue, fever.

You will be interested in:Why the coccyx hurts are common causes

- complete or incomplete combination of bronchial asthma, recurrent nasal polyposis or paranasal sinuses and intolerance to acetylsalicylic acid and other NSAIDs (including in the anamnesis);

- erosive and ulcerative changes in the mucous membrane of the stomach and duodenum;

- active gastrointestinal hemorrhage;

- cerebrovascular or other bleeding;

- Inflammatory bowel disease (Crohn's disease, ulcerative colitis) in the phase of exacerbation;

- Violations of blood clotting, incl. hemophilia;

Decompensated heart failure;

- liver failure or active liver disease;

- severe renal failure (QC

A source: https://health.yandex.ru/pills/ketorol-33817

Ketorol - instructions for use, counterparts, price, reviews

Ketorol belongs to the group of non-steroidal anti-inflammatory drugs with a pronounced analgesic effect. Active active substance of this drug is ketorolac tromethamine.

Active substance

Ketorolac.

Form of issue and composition

The drug is released as a solution for intravenous and intramuscular injection, film-coated tablets, gel for external use.

Ketorol, coated tablets 1 tab.
ketorolac tromethamine (ketorolac trometamol) 10 mg
Auxiliary components: microcrystalline cellulose, lactose, corn starch, silicon dioxide colloid, magnesium stearate, sodium carboxymethyl starch (type A). Composition of the film shell: hypromellose, propylene glycol, titanium dioxide, olive green (dye quinoline yellow 78%, dye brilliant blue 22%).
Ketorol, solution for intravenous and intramuscular administration 1 ml
ketorolac tromethamine (ketorolac trometamol) 30 mg
Auxiliary components: octoxynol, disodium edetate, sodium chloride, ethanol, propylene glycol, sodium hydroxide, water d / u.
Ketorol, gel for external use 2% 1 g
ketorolac tromethamine (ketorolac trometamol) 20 mg
Auxiliary components: propylene glycol, dimethylsulfoxide, carbomer 974P, sodium methylparahydroxybenzoate, sodium propylparahydroxybenzoate, tromethamine (trometamol), Purified water, Drimon Inde flavoring (0.09% triethyl citrate, 0.14% castor oil oil, 0.3% isopropyl myristate, 24.15% is diethyl phthalate), ethanol, glycerol.

Indications for use

Ketorol is taken to relieve severe and moderately severe pain syndrome with trauma, toothache, postpartum and postoperative pain, with oncological diseases, myalgia, arthralgia, neuralgia, radiculitis, dislocations and sprains, rheumatic diseases.

Contraindications

Ketorol is contraindicated in hypersensitivity to tromethamine ketorolac, aspirin triad, that is, when combined bronchial asthma, recurrent nasal polyposis and paranasal sinuses and intolerance of ASA and drugs of pyrazolone series, with hypovolemia of any etiology, with exacerbations of erosive and ulcerative lesions of the gastrointestinal tract, hypocoagulation, including hemophilia, bleeding or high risks of their development, severe renal failure, liver failure, dehydration, peptic ulcers, hemorrhagic stroke. Also, the drug is not prescribed during labor, during pregnancy and breastfeeding and children under 16 years of age.

The use of ketorol is possible with caution in conditions such as intolerance to other NSAIDs, the presence of factors that increase Gastrointestinal toxicity, such diseases as bronchial asthma, cholecystitis, arterial hypertension, cholestasis, active hepatitis, harmful habits (alcoholism, smoking), postoperative recovery, chronic heart failure, edematous syndrome, sepsis, age over 65 years of age.

Instructions for use Ketorol (method and dosage)

Tablets, film-coated

Take inside a single dose of 10 mg.

In severe pain syndrome, repeated use of 10 mg to 4 times a day, depending on the severity of pain. The maximum daily dose is 4 mg. It should take a minimum effective dose of no more than 5 days.

When switching from a parenteral preparation to oral administration, the total daily dose of both dosage forms per day translation should not exceed 90 mg for people from 16 to 65 years and 60 mg for people over 65 years of age or with a disruption of function kidney. The dose of the drug in tablets on the day of transition should not exceed 30 mg.

Solution for intramuscular and intravenous administration

When ingested, adults are shown from 10 mg every 4-6 hours to 20 mg every 6-8 hours.

Intravenously administered 10-30 mg at intervals of 4-6 hours for 2 days.

The maximum dose for ingestion or intramuscular injection is 90 mg per day, for patients with body weight, renal dysfunction or over 65, 60 mg per day.

Gel for external use

Before applying, the surface of the skin is recommended to be washed and dried. On the area of ​​maximum soreness, 1-2 cm of gel is applied 3-4 times a day and rubbed with a uniform layer with soft massaging movements.

Repeated dose is given after 4 hours. The gel is used not more than 4 times a day.

If there are no improvements after 10 days of use, discontinue treatment and consult a doctor. It is not recommended to apply the gel for more than 10 days without consulting a doctor.

Side effects

The use of the drug often causes such side effects as gastralgia, diarrhea, flatulence, constipation, vomiting, headache, dizziness, drowsiness, burning or pain at the injection site, skin rash, puffiness, increased sweating.

Less often the drug causes a decrease in appetite, the appearance of erosive and ulcerative lesions of the gastrointestinal tract, cholestatic jaundice, hepatitis, acute pancreatitis, acute renal failure, back pain, hematuria, nephritis, increased frequency of urination, hearing loss, ringing in the ears, bronchospasm, rhinitis, pulmonary and laryngeal edema, convulsions, anxiety, depression, psychosis, fainting state. Also possible anemia, eosinophilia, leukopenia, epistaxis, various allergic reactions, fever.

Overdose

When the dose is exceeded, symptoms such as abdominal pain, nausea, vomiting, peptic ulcers, metabolic acidosis, impaired renal function appear.

It shows gastric lavage, the appointment of adsorbents and symptomatic treatment to maintain the vital functions of the body. Dialysis is ineffective.

Analogues

Analogues according to ATC code: Ketorolac, Dolak, Adolor, Ketanv, Torolak.

Do not make the decision to replace the drug yourself, consult a doctor.

pharmachologic effect

Ketorol has a predominantly analgesic effect. Ketorolac tromethamine, the active ingredient of the drug, has a moderate antipyretic property, anti-inflammatory effect and pronounced analgesic effect.

In peripheral tissues leads to an indiscriminate suppression of the activity of cyclooxygenase enzymes 1 and 2 types, due to which the process of prostaglandin formation is inhibited.

It is prostaglandins - the main factor of the appearance of pain, inflammation reactions and the mechanism of thermoregulation.

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The use of ketorol does not cause drug dependence, since the active substance of the drug does not affect receptors to opioids, does not cause oppression of the respiratory center and has no calming or antidepressant effect. The analgesic effect of this drug is comparable in effectiveness to morphine and is significantly superior to other non-steroidal anti-inflammatory drugs.

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After intramuscular injections or ingestion of tablets, the analgesic effect occurs after 30 and 60 minutes, respectively. The peak of the analgesic effect of the drug is achieved in 1-2 hours.

With intramuscular injections Ketorol the drug is quickly and completely absorbed. With the ingestion of Ketorol tablets, the active ingredient is also rapidly and well absorbed in the gastrointestinal tract. The drug penetrates into breast milk.

More than half of the injected drug is metabolized in the liver with the formation of pharmacologically inactive metabolites. Excretion of the drug is carried out mainly by the kidneys, partially through the intestine.

The drug is not excreted by hemodialysis.

special instructions

The introduction of the first dose of the drug should be under the supervision of a doctor because of the high risk of allergic reactions. The drug is not recommended for use for purposes of premedication, maintenance of anesthesia.

Joint reception with other non-steroidal anti-inflammatory drugs can cause fluid retention, cardiac decompensation, increased blood pressure.

In case of bleeding disorders, Ketorol should be administered with continuous monitoring number of platelets, especially this is relevant for patients after operations that need control hemostasis.

Lengthening the course of treatment increases the risk of developing drug complications.

During treatment with this medication, care should be taken when driving vehicles and practicing other potentially hazardous activities.

At pregnancy and thoracal feeding

Contraindicated in pregnancy, childbirth, breast-feeding.

In childhood

Contraindicated for children under 16 years.

In old age

Patients over 65 years of age should be administered with caution.

In case of violations of kidney function

Contraindicated in cases of severe renal failure.

With violations of liver function

Contraindicated in cases of severe hepatic insufficiency.

Drug Interactions

Ketorol when taken with acetylsalicylic acid or other NSAIDs, calcium preparations, GCS, ethanol, corticotropin can cause ulceration of the gastrointestinal tract and the development of gastrointestinal bleeding.

Ketorol increases the effect of other nephrotoxic drugs. Simultaneous administration with paracetamol increases the toxic effect on the kidneys, with methotrexate - on the kidneys and liver. If a simultaneous use with methotrexate is required, the dose of the latter should be reduced.

Probenecid increases the concentration of Ketorol in blood plasma. Against the background of the use of ketorolac, a decrease in the clearance of methotrexate and lithium is possible, as well as an increase in the toxicity of these substances.

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The combination with indirect anticoagulants, heparin, thrombolytic agents, antiaggregants, cefoperazone, cefotetan and pentoxifylline increases the risk of bleeding.

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The drug reduces the effect of antihypertensive and diuretic drugs.

Against the background of taking Ketorol, the dose of opioid analgesics can be significantly reduced.

The drug enhances the hypoglycemic effect of insulin and oral hypoglycemic drugs, which requires dose adjustment.

The combination with valproic acid causes disruption of platelet aggregation. Increases the concentration in the blood plasma of verapamil and nifedipine.

The clearance of ketorolac can be reduced by drugs that block tubular secretion.

Conditions of leave from pharmacies

It is released by prescription.

Terms and conditions of storage

Store in a dry place, protected from light, out of reach of children, at a temperature of no higher than 25 ° C. Shelf life - 3 years.

Price in pharmacies

Price Ketorol for 1 package starts from 39 rubles.

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