{"id":4101,"date":"2025-03-31T18:11:58","date_gmt":"2025-03-31T18:11:58","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/ketorolac-trometamol-txt\/"},"modified":"2025-03-31T18:11:58","modified_gmt":"2025-03-31T18:11:58","slug":"ketorolac-trometamol-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/ketorolac-trometamol-txt\/","title":{"rendered":"Ketorolac trometamol.txt"},"content":{"rendered":"

Ketorolac trometamol <\/h1>\n

CLINICAL USE <\/H3>
\nShort-term management of moderate to severe acute postoperative pain

DOSE IN NORMAL RENAL FUNCTION <\/H3>Oral: 10 mg every 4\u20136 hours (elderly every 6\u20138 hours); maximum 40 mg daily; maximum duration 7 daysIM\/IV: initially 10 mg, then 10\u201330 mg when required every 4\u20136 hours (every 2 hours in initial postoperative period); maximum 90 mg daily (elderly and patients less than 50 kg: maximum 60 mg daily); maximum duration 2 days

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :376.4<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :>99<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : Approx 60<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :0.15<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :IM dose: 3.5\u20139.2\/5.9\u201319.2

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Maximum 60 mg daily
  • 10 to 20 &nbsp &nbsp : Avoid if possible. Use small doses and monitor closely
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Avoid if possible. Use small doses and monitor closely

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in GFR <10 mL\/min<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unlikely to be dialysed. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR 10 to 20 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugsACE inhibitors and angiotensin-II antagonists: antagonism of hypotensive effect; increased risk of nephrotoxicity and hyperkalaemia\n
  • Analgesics: avoid concomitant use of 2 or more NSAIDs, including aspirin (increased risk of side effects and haemorrhage)\n
  • Antibacterials: possibly increased risk of convulsions with quinolonesAnticoagulants increased risk of bleeding with heparins, phenindione and coumarins \u2013 avoid concomitant use; increased risk of haemorrhage with parenteral ketorolac and heparin \u2013 avoid concomitant use\n
  • Antidepressants: increased risk of bleeding with SSRIs and venlaflaxineAntidiabetics: effects of sulphonylureas possibly enhanced\n
  • Anti-epileptics: effect of phenytoin possibly enhanced\n
  • Antivirals: increased risk of haematological toxicity with zidovudine: concentration possibly increased by ritonavir\n
  • Ciclosporin: increased risk of nephrotoxicityCytotoxics: excretion of methotrexate reduced; increased risk of bleeding with erlotinib\n
  • Diuretics: increased risk of nephrotoxicity; antagonism of diuretic effect; hyperkalaemia with potassium-sparing diuretics\n
  • Lithium: excretion of lithium reduced \u2013 avoid concomitant usePentoxifylline: risk of ketorolac associated bleeding increased\u2013 avoid concomitant useProbenecid: delays excretion of ketorolac \u2013 avoid concomitant use\n
  • Tacrolimus: increased risk of nephrotoxicity

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>IM, IV, oral

    Rate of Administration <\/H4>IV bolus over no less than 15 seconds

    Comments<\/H4>Compatible with sodium chloride 0.9%, glucose 5%, Ringers, lactated Ringers or plasmalyte solutionsKetorolac trometamol.KEToroLAC TroMETAMoL 411

    OTHER INFORMATION <\/H4>Drugs that inhibit prostaglandin biosynthesis (including NSAIDs) have been reported to cause nephrotoxicity, including, but not limited to, glomerular nephritis, interstitial nephritis, renal papillary necrosis, nephrotic syndrome and acute renal failure. In patients with renal, cardiac or hepatic impairment, caution is required since the use of NSAIDs may result in deterioration of renal functionKetorolac and its metabolites are excreted primarily by the kidneyReported renal side effects include increased urinary frequency, oliguria, acute renal failure, hyponatraemia, hyperkalaemia, haemolytic uraemic syndrome, flank pain (with or without haematuria), raised serum urea and creatinine.
    \n","protected":false},"excerpt":{"rendered":"

    Ketorolac trometamol CLINICAL USE Short-term management of moderate to severe<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4101","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4101","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4101"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4101\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4101"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4101"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4101"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}