The active substance is ketorol ketorolac which inhibiting activity of the enzyme cyclooxygenase, contributes inhibition of the biosynthesis of prostaglandins, which are modulators of inflammation, pain and thermoregulation sensitivity.
Analgesic effect Ketorol injections can be seen in half an hour after administration and the maximum effect - after 1-2 hours. Ketorol therapeutic effect is maintained for 4-6 hours.
Release form and composition
Ketorol released in the form of:
- Solution - light yellow (or colorless) transparent (in dark glass ampoules, 1 ml);
- Gel - a transparent (translucent) uniform, with a characteristic smell (in tubes of aluminum, laminated to 30 g);
- Tablets, film-coated - green round biconvex, embossed letter «S» on one of the sides (10 pieces in blister packs.);
The active substance - ketorolac tromethamine (ketorolac trometamol)
- In 1 g of the gel - 20 mg;
- 1 tablet - 10 mg;
- In 1 ml - 30 mg.
- Tablets: Microcrystalline Cellulose - 121 mg Sodium carboxymethylstarch (type A) - 15 mg Magnesium stearate - 2 mg colloidal silicon dioxide - 4 mg Lactose - 15 mg maize starch - 20 mg;
- A solution of sodium hydroxide - 0.725 mg, octoxynol - 0.07 mg Disodium edetate - 1 mg, propylene glycol - 400 mg Sodium chloride - 4.35 mg Water for injection - up to 1 ml ethanol - 0.115 ml;
- Gel: Tromethamine (trometamol) - 15 mg Propylene Glycol - 300 mg, flavor "Indus Drimon" (triethyl citrate - 0.09%, isopropyl myristate - 0.3% castor bean seed oil - 0.14% diethylphthalate - 24.15%) - 3 mg Carbomer 974P - 20 mg Glycerol - 50 mg Purified water - 390 mg, dimethylsulfoxide - 150 mg propyl parahydroxybenzoate Sodium - 0.2 mg methyl parahydroxybenzoate Sodium - 1.8 mg Ethanol - 50 mg.
Composition of film coating tablets: olive green (brilliant blue dye 22% quinoline yellow dye 78%) - 0.1 mg; Hypromellose - 2.6 mg; titanium dioxide - 0.33 mg; propylene glycol - 0.97 mg.
In the form of tablets Ketorol solution and used for relief of pain of various genesis medium and strong intensity:
- Sciatica, neuralgia;
- Myalgia, arthralgia;
- Sprains, strains and other injuries and their consequences;
- Rheumatic diseases;
- Pain in the postoperative and postpartum;
- Oncological diseases.
In a gel preparation is applied topically in pain syndromes of the following diseases:
- Sciatica, neuralgia;
- Arthralgia, myalgia;
- Bursitis, epicondylitis, tendinitis, synovitis;
- Rheumatic diseases;
- Injury (damage to the ligaments, bruises and inflammation of the soft tissues, including post-traumatic origin).
Ketorol - a non-steroidal anti-inflammatory agent with analgesic effects advantageously. The active ingredient of the drug - ketorolac (ketorolac tromethamine). Ketorolac has a moderate antipyretic property pronounced anti-inflammatory effect and analgesic effect. Ketorolac predominantly in peripheral tissues causes suppression activity indiscriminate enzymes cyclooxygenase type 1 and 2, whereby formation observed inhibition prostaglandins.
Prostaglandins play an important role in the appearance of pain, inflammation reactions and mechanism of thermoregulation. By active ingredient ketorol chemical structure - racemic mixture of + R- and -S- enantiomers, the analgesic effect of the drug caused by it -S-enantiomers. Ketorol not affect opioid receptors, without depressing the respiratory center, it does not have a calming effect and protivodepressivnym not cause drug dependence. Analgesic effect ketorol in strength comparable to morphine and are much more superior to non-steroidal anti-inflammatory agents other groups.
Starting analgesic effect after intramuscular administration, or oral administration begins after 0.5 and 1 h, respectively. The maximum analgesic effect is observed within 1-2 hours.
Is contraindicated in case of hypersensitivity to ketorolac tromethamine, aspirin triad, ie the combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses and intolerance to ASA drugs and pyrazolone series.
Among other things among the contraindications:
- hypovolemia of any etiology,
- acute erosive and ulcerative lesions of the gastrointestinal tract,
- hypocoagulation, including hemophilia,
- bleeding or a high risk of their development,
- severe renal insufficiency,
- liver failure,
- peptic ulcers,
- hemorrhagic stroke.
Not indicated during childbirth, during pregnancy and breast-feeding and children under 16 years.
Application ketorol possible with caution in conditions such as intolerance to other NSAIDs, the presence of factors that increase GI-toxicity, diseases such as bronchial asthma, cholecystitis, hypertension, cholestasis, active hepatitis, harmful habits (alcoholism, smoking), postoperative recovery, chronic heart failure, edema syndrome, sepsis, age over 65 years.
Ketorol tablets and injections can provoke patients such undesirable reactions as:
- leukopenia (increase in white blood cells), eosinophilia (increase in the number of eosinophils), anemia (decrease in red blood cell count or hemoglobin);
- rectal, nasal, bleeding from post-operative wounds;
- purpura, rash, urticaria, Lyell syndrome (allergic dermatitis as a reaction to drugs drugs), Stevens-Johnson syndrome (appearance of bubbles on the skin and on the mucosa of various authorities);
- diarrhea, stomach pain, vomiting, constipation, flatulence, stomatitis, nausea, heartburn;
- pain, acute renal failure, frequent urination, nephritis (inflammation of the kidney), decrease or increase the volume of urine;
- bronchial spasm, laryngeal edema, rhinitis;
- headache, drowsiness, dizziness, hyperactivity, depression, tinnitus, hearing loss, blurred vision.
- increased blood pressure, syncope, pulmonary edema;
- itching, rash, changes in skin color, skin rash, edema of the eyelids, difficulty breathing, wheezing, heaviness in the chest;
- weight gain, swelling of the feet, toes, ankles, legs, face, tongue, excessive sweating, fever;
- pain or burning sensation at the injection site Ketorol.
Instructions for use
Assigned to ingestion. Depending on the degree of severity of pain and are used once or repeatedly at a dose of 10 mg (maximum allowable dose - 4 tablets per day - 40 mg). 1 Duration of treatment - no more than 5 days.
Individually selected minimum effective dose, which depends on the therapeutic response of the patient and the intensity of pain. If it is necessary that you can assign a number of smaller doses of opioid analgesics.
Up to 65 years are used intramuscularly 10-30 mg dose once or repeatedly (every 4-6 hours) at 10-30 mg. Patients over 65 years, as well as with impaired renal function Ketorol administered intramuscularly 10-15 mg once or repeatedly 10-15 mg every 4-6 hours depending on the severity of pain syndrome.
The maximum permissible dose for patients up to 65 years - 90 mg / day. When renal impairment or age of 65 the maximum permissible dose is 60 mg / day. The course of treatment - no more than 5 days.
The transition from the internal intramuscular application
The transition ketorol day dose for oral administration should not exceed 30 mg. The daily total dose of tablets and solution during the transition from intramuscular injection to intake must be less than 90 mg / day for patients of 65 years or less, for patients with impaired renal function or older than 65 years - 60 mg / day.
In excess doses symptoms such as abdominal pain, nausea, vomiting, peptic ulcers, metabolic acidosis, impaired renal function. It is shown gastric lavage, the appointment of adsorbents and symptomatic treatment in order to maintain vital body functions. Dialysis is ineffective.
Before the appointment of the drug necessary to find out whether the patient has had previous allergic reactions to Ketorol or NSAIDs. Because of the risk of allergic reactions, the first dose should be under close medical supervision.
Hypovolemia increases the risk of nephrotoxic adverse reactions.
If necessary, the drug can be used in combination with a narcotic analgesic.
Ketorol not recommended for use as a drug for sedation, as well as the maintenance of anesthesia at high surgical interventions.
While the use of other NSAIDs may experience cardiac decompensation, fluid retention, high blood pressure. Effect on platelet aggregation is terminated after 1-2 days.
The medicament may change the properties of platelets, but does not replace the prophylactic effect of aspirin in cardiovascular diseases.
In case of violation clotting drug is prescribed only under the constant control of the number of platelets. It is especially important for post-surgical patients requiring careful hemostasis control.
The risk of drug complications increases with increasing dose (90 mg daily) and elongation therapy.
omeprazole prescribed to reduce the risk of NSAID-gastropathy, misoprostol, antacid drugs.
The gel should be applied only to intact areas of skin and to avoid its contact with open wounds, in the eyes and mucous membranes. Can not be applied on top of the drug airtight bandage. After application of the gel should be thoroughly wash your hands with soap and water. After each use the tube to be tightly closed.
Patients during therapy should be careful in the management of potentially hazardous activities that require increased attention and psychomotor speed reactions.
Possible undesirable (including heavy) reaction:
- ASA and other NSAIDs, corticosteroids, calcium preparations, corticotropin, ethanol - formation of gastrointestinal ulcers, development of gastrointestinal bleeding;
- Paracetamol and other nephrotoxic agents, including gold preparations - nephrotoxicity;
- Methotrexate - hepato-and nephrotoxicity;
- lithium Formulations - reduced clearance and increased toxicity;
- Indirect anticoagulants, antiplatelet agents, thrombolytics, heparin, pentoxifylline, tsefotetan, ceftazidime - the development of bleeding;
- Valproic acid - violation of platelet aggregation;
- Verapamil and nifedipine - increasing their plasma concentrations.
Ketorolac enhances hypoglycemic effect of insulin and of oral hypoglycemic drugs, however requires recalculation of dose; reduces the effectiveness of antihypertensive and diuretics.
Probenecid, and drugs that block tubular secretion, reduce the clearance of ketorolac and increase its concentration in the blood plasma.
In appointing ketorol with narcotic analgesics, their doses significantly reduced.
Antacids do not affect the absorption of ketorolac.
The period of treatment should not be applied other nonsteroidal antiinflammatory drugs.
Real testimonials of people about tablets Ketorol:
- Sasha. "Ketorol" has become an indispensable tool in my medicine cabinet. When a headache or a tooth, immediately accept it. Through 15 minutes pills take effect. The pain goes away and does not return for a long time. I was plagued by severe pain during menstruation, and is an effective and inexpensive means of regularly helps me. The tablets are small, covered with a smooth shell, so very easy to swallow. With the side effects I have not experienced, but often take pain medication is not recommended.
- Nastya. Previously I used the pills Ketanov. Benefited from any kind of pain - whether it be the head, stomach, teeth - anything. Once at the pharmacy said it was too strong antibiotic and for frequent use is not suitable, advised Ketorol as safer for the liver analog. I would say that it is not worse. The action begins in 15-20 minutes, it not only relieves pain, but also heals. As for the downsides - A bit sleepy right after the reception, but it quickly passes.
- Alyona. Excellent cure me orthodontist appointed, while wearing braces. Jaw ached terribly, I never thought that bone pain is so unbearable. "Ketorol" really me then handed. Action noticeable 15-25 minutes after taking, in my case, the duration of analgesic effect was about four and a half or five hours, then drank another. More than three tablets a day, I try not to take. I can only say that "Ketorol" perfect cure for a good price, other drugs, which are taken to be much more expensive and did not help.
Analogs tablets Ketorol
Similar in therapeutic effect of pills Ketorol are the following medications:
- Ketanov tablets;
Conditions of supply and storage
The drug is available in the pharmacy with a prescription. Keep the tablets away from children is recommended in a dark cool place. Shelf life medication should not exceed 3 years, after which the drug can not be taken orally.
The average cost of Ketorol tablets in Moscow pharmacies is 56 rubles for 2018.