Monograph Details
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Pain & Pyrexia
> Nonnarcotic analgesics
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Ketorolac IV/IM |
| Manufacturer |
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Various generic manufacturers |
| Legal Classification |
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Rx
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| Pharmacological Class |
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NSAID (pyrrolo-pyrole deriv). |
| Generic Name |
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Ketorolac tromethamine 15mg/mL, 30mg/mL; for IM or IV inj; contains alcohol. |
| Indications |
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Management of moderately severe, acute pain requiring opioid-level analgesia. |
| Children |
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<2yrs: not recommended. 2–16yrs: 1mg/kg (max 30mg) IM once; or 0.5mg/kg (max 15mg) IV once. |
| Adults |
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Do not exceed 5 days' combined (inj + tabs) therapy or recommended dose (may use as-needed opioids for breakthrough pain if appropriate). 16–65yrs (normal renal function): 60mg IM or 30mg IV once; or, 30mg IM or IV every 6 hours. ≥65yrs, or <110lbs, or renal impairment: 30mg IM or 15mg IV once; or, 15mg every 6 hours. |
| Contraindications |
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Aspirin allergy. Peptic ulcer. GI bleed or perforation. Advanced renal impairment. Hypovolemia. Pre-op or intra-operative use when hemostasis is critical. Cerebrovascular bleeding. Hemorrhagic diathesis. Incomplete hemostasis. Bleeding disorders or high risk of bleeding. Coronary artery bypass graft surgery. Concomitant probenecid, salicylates, other NSAIDs. Epidural or intrathecal inj. Labor & delivery. Late pregnancy. Nursing mothers. |
| Precautions |
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Not for pre-op use. Renal or hepatic dysfunction. Discontinue if abnormal liver function tests occur. Correct hypovolemia first. Hypertension. Cardiac decompensation. Coagulation disorders. May prolong bleeding time. Asthma. Elderly. Debilitated. Children: increased risk of bleeding after tonsillectomy. Pregnancy (Cat.C). |
| Interactions |
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See Contraindications. Monitor anticoagulants closely. Antagonizes furosemide, possibly antiepileptics. May increase serum lithium, methotrexate levels. ACEIs, diuretics increase renal toxicity risk. Hallucinations with fluoxetine, thiothixene, alprazolam. Apnea with non-depolarizing muscle relaxants. |
| Adverse Reactions |
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Headache, GI pain/fullness, dyspepsia, other GI effects, dizziness, drowsiness, edema, inj site pain, hypertension, pruritus, rash (discontinue if occurs), stomatitis, purpura, sweating, peptic ulcer, GI bleed/perforation, bleeding, renal or liver failure, anaphylaxis. |
| How Supplied |
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Contact supplier. |
| Additional Resources |
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• Related Prescribing Note |
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