Ketorol tablets: instructions for use

Ketorol, a drug whose active ingredient is ketorolac, belongs to the NSAID, has an analgesic, anti-inflammatory and antipyretic effect.

It is used to eliminate pain syndrome of varying intensity and different etiology (including postoperative pain and cancer pain).

On this page you will find all information about Ketorol: the full instructions for use on this medication, average prices in pharmacies, complete and incomplete analogs of the drug, as well as reviews of people who have already applied Ketorol. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

NSAIDs with a pronounced analgesic effect.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much are Ketorol tablets? The average price in pharmacies is at the level of45 rubles.

Form of issue and composition

Ketorol is released in the form of tablets coated with a special soluble shell of green color. The biconvex form of the tablet facilitates the process of swallowing the drug.

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In the composition of all dosage forms of Ketorol, ketorolac in various concentrations is included as the active substance. Thus, 10 mg of ketorolac are contained in tablets, 30 mg in 1 ml in solution, and 20 mg in 1 g (2%) in the gel.

Each tablet has a special embossing in the form of the Latin letter S. Tablets are packaged in 10 pieces in a plastic blister with a metal coating. In the package there may be a different number of blisters, from which the price of the drug is fundamentally different.

Pharmacological effect

Ketorol is a non-steroidal anti-inflammatory drug with predominantly analgesic effect. The active substance of the drug is ketorolac (ketorolac tromethamine). Ketorolac has a moderate antipyretic effect, anti-inflammatory effect and pronounced analgesic effect.

Ketorolac mainly in peripheral tissues induces indiscriminate inhibition of enzyme activity cyclooxygenase 1 and 2 types, as a result of which inhibition of the formation of prostaglandins is observed. Prostaglandins play an important role in the appearance of pain, inflammatory reactions and the mechanism of thermoregulation. According to the chemical structure, the active substance Ketorol is a racemic mixture of + R- and -S-enantiomers, and the analgesic effect of the drug is due to the -S-enantiomers.

Ketorol does not affect the receptors for opioids, does not depress the respiratory center, does not have a calming and anti-depressant effect, does not cause drug dependence. The analgesic effect of Ketorol is comparable in strength to morphine and much more than non-steroidal anti-inflammatory drugs of other groups. The onset of analgesic action after intramuscular injection or oral administration begins at 0.5 and 1 hour, respectively. The maximum analgesic effect is observed after 1-2 hours.

Indications for use

In the form of a solution and tablets, Ketorol is used to arrest the pain syndrome of different genesis of medium and strong intensity:

Dislocations, sprains, other injuries and their consequences;
Rheumatic diseases;
Toothache;
Radiculitis, neuralgia;
Myalgia, arthralgia;
Pain in the postoperative and postpartum period;
Oncological diseases.

In the form of a gel, the drug is used topically for pain syndrome caused by the following diseases:

Bursitis, epicondylitis, tendinitis, synovitis;
Rheumatic diseases;
Radiculitis, neuralgia;
Arthralgia, myalgia;
Injuries (damage to ligaments, bruises and inflammation of soft tissues, including post-traumatic origin).

Contraindications

Before taking the drug, the patient is recommended to carefully study the accompanying instructions, since Ketorol tablets are contraindicated in the presence of the following conditions:

Bronchial asthma;
Hyperkalemia;
Lactase insufficiency;
Patients under 16 years of age;
Pregnancy and the period of breastfeeding;
Gastrointestinal bleeding or suspicion of them;
Ulcerative colitis or Crohn's disease in the phase of exacerbation;
Attacks of suffocation in the anamnesis, bronchospasm, frequent obstructing bronchitis;
Severe liver and kidney damage, accompanied by a violation of these organs;
Hereditary blood diseases, accompanied by a violation of its coagulation function;
Individual intolerance to acetylsalicylic acid or drugs from the group of non-steroidal anti-inflammatory drugs;
Chronic diseases of the organs of the gastrointestinal tract with the presence of ulcerative-erosive surfaces

Relative contraindications include:

Cardiac ischemia;
Diabetes;
Heart failure;
Arterial hypertension;
Cholestasis;
Age of patients older than 60;
Simultaneous reception of anticoagulants or antiplatelet agents.

Application in pregnancy and lactation

The solution and tablets are contraindicated in pregnancy and breastfeeding.

External application is allowed in the first and second trimesters, but after 27 weeks, the use of the gel may cause a miscarriage of pregnancy or a complicated course of labor.

Instructions for use

The instructions for use indicate that Ketorol tablets are taken orally in a single dose of 10 mg.

In severe pain, the drug is taken repeatedly for 10 mg up to 4 times / day, depending on the degree of pain. The maximum daily dose is 40 mg. The minimum effective dose should be used. 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 is not should exceed 90 mg for patients aged 16 to 65 years and 60 mg for patients over 65 years of age or with impaired renal function. In this case, the dose of the drug in tablets on the day of transition should not exceed 30 mg.

Side effects

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

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

Overdose

Possible signs of Ketorol overdose: nausea, abdominal pain, vomiting, peptic ulcers or erosive lesions of the gastrointestinal tract, metabolic acidosis, impaired renal function.

Treatment: gastric lavage followed by the appointment of adsorptive drugs, symptomatic treatment. It is not derived largely by dialysis methods.

special instructions

When using tablets for more than 5 days, the risk of side effects in the patient increases, so if there is no expected therapeutic effect, you should consult a doctor again.
If there is a significant pain syndrome or if there are contraindications for the oral administration of the drug Ketorol is administered to the patient in the form of a solution for injection.
To reduce the risk of development of a drug ulcer, the patient can simultaneously administer antacid or enveloping tablets together with Ketorol tablets drugs that allow to reduce the irritating effect of the main substance of the tablet on the mucous membranes of the digestive tract.
Patients with blood clotting disorders during the treatment with the drug should constantly monitor the level of platelets in the blood, especially in the case of postoperative patients.

During drug treatment, patients should be careful when driving vehicles and managing complex devices that require increased concentration.

Drug Interactions

Ketorolac enhances the hypoglycemic action of insulin and oral hypoglycemic drugs, so it is necessary to recalculate their doses; reduces the effectiveness of antihypertensive and diuretic drugs.

When Ketorol is prescribed with narcotic analgesics, their doses are significantly reduced.

Antacids do not affect the absorption of ketorolac.

Probenecid and drugs that block tubular secretion, reduce the clearance of ketorolac and increase its concentration in the blood plasma.

Possible adverse (including severe) reactions:

Methotrexate - hepato- and nephrotoxicity;
Valproic acid is a violation of platelet aggregation;
Lithium preparations - reduced clearance and increased toxicity;
Paracetamol and other nephrotoxic drugs, including gold preparations - nephrotoxicity;
ASA, other NSAIDs, glucocorticosteroids, calcium preparations, corticotropin, ethanol - formation of gastrointestinal ulcers, development of gastrointestinal bleeding;
Indirect anticoagulants, antiaggregants, thrombolytics, heparin, pentoxifylline, cefotetan, cefoperazone - development of bleeding;
Verapamil and nifedipine - increasing their concentration in blood plasma.

During the treatment period, other non-steroidal anti-inflammatory drugs should not be used.

Reviews

We picked up some of the people's feedback on Ketorol:

Anatoly. Recently there was an unfortunate misunderstanding: ALL of the remaining teeth fell ill at once. After a cold. It happens. I immediately for my checked tablets - and they are overdue. For a year. I ran to the pharmacy. Well, they gave it to me (I mispronounced the name !?) not ketorol, but ketonal. I took a pill - wait half an hour - does not take. I swallowed the second, already drinking water... DOES NOT take it. Something in my head clouded, but the pain does not stop. It turns out that what I was given at the pharmacy - toothache (plainly) does not stop. Later, after the treatment of the main culprit tooth, I took ketonal. And it worked! That is... he eased the pain, but the pain is not acute dental, but the one that is already in the decay stage. Well, ketorol is a proven remedy for any toothache (I do not know how, with injuries, it was not necessary, fie-fie-fie!). Effective after 20-30 minutes. With warm water faster. But do not take more than 2 days - to the surgeon. Because the tooth somehow ketorol does not heal.
Lera. Ketorol is a good remedy for pain, it helps almost instantly - it is very effective from various pains (personally it helped me from a toothache and when I hurt my foot), but like any medicine has a big a list of contraindications, many complain of stomach problems (especially gastritis, pain starts after taking it), and I have a reaction to the head - there is lethargy, drowsiness, inhibition, in the eyes flies fly, as happens with hypertensive crisis, so I now try not to use this medicine and be extremely careful in using any painkillers.