Indications
Ketorolac Tromethamine is indicated for the short-term management of moderate to severe acute post-operative pain.

Pharmacology
Ketorolac Tromethamine could be a powerful pain relieving of the non-steroidal anti-inflammatory drugs (NSAIDs). It acts by repressing the cyclooxygenase protein framework and thus restrains the prostaglandin amalgamation. It illustrates a negligible anti-inflammatory impact at its pain relieving dosage.

Dosage & Administration
Tablet- Recommended dose is 10 mg every 4-6 hours. It should be used short-term only (up to 7 days) and are not recommended for chronic use. Doses exceeding 40 mg/day is not recommended.

Injection- Ketorolac injection may be used as a single or multiple doses, on a regular or when necessary schedule for the management of moderately severe, acute pain that requires analgesia at the opioid level, usually in a postoperative setting. When administering Ketorolac injection, the IV bolus must be given over no less than 15 seconds. The IM administration should be given slowly and deeply into the muscle. The analgesic effect begins within 30 minutes with maximum effect in 1 to 2 hours after dosing IV or IM. Duration of analgesic effect is usually 4 to 6 hours.

Single-Dose Treatment-

IM Dosing (Adult):

• Patients <65 years of age: One dose of 60 mg.
• Patients >65 years of age, renally impaired and/or less than 50 kg of body weight: One dose of 30 mg.

IV Dosing (Adult):

• Patients <65 years of age: One dose of 30 mg.
• Patients >65 years of age, renally impaired and/or less than 50 kg of body weight: One dose of 15 mg.

IV or IM Dosing (2 to 16 years of age):

• IM Dosing: One dose of 1 mg/kg up to a maximum of 30 mg.
• IV Dosing: One dose of 0.5 mg/kg up to a maximum of 15 mg.

Multiple-Dose Treatment (IV or IM)-

• Patients <65 years of age: The recommended dose is 30 mg Ketorolac injection every 6 hours. The maximum daily dose should not exceed 120 mg. Patients >65 years of age, renally impaired patients and patients less than 50 kg: The recommended dose is 15 mg Ketorolac injection every 6 hours. The maximum daily dose for these populations should not exceed 60 mg. For breakthrough pain, do not increase the dose or the frequency of Ketorolac Tromethamine.
• Conversion from Parenteral to Oral Therapy: Ketorolac tablets may be used either as monotherapy or as follow-on therapy to parenteral Ketorolac. When Ketorolac tablets are used as a follow-on therapy to parenteral Ketorolac, the total combined daily dose of ketorolac (oral + parenteral) should not exceed 120 mg in younger adult patients or 60 mg in elderly patients on the day the change of formulation is made. On subsequent days, oral dosing should not exceed the recommended daily maximum of 40 mg. Ketorolac IM should be replaced by Ketorolac tablet as soon as feasible. The total duration of combined parenteral and oral treatment should not exceed 5 days.

Interaction
Other NSAIDs or headache medicine: Increment the side impacts of ketorolac Tromethamine. Anti-coagulants: Improve anti-coagulant effect. Beta Blocker: Diminish the anti-hypertensive impact . ACE Inhibitors: Increment the chance of renal impairment. Methotrexate: Upgrade the harmfulness of methotrexate.

Contraindications
Ketorolac is contraindicated in patients having extreme touchiness to this medicate or other NSAIDs. It ought to not be utilized in children beneath 16 a long time of age. lt is additionally contraindicated as prophylactic pain relieving some time recently surgery.

Side Effects
Commonly happening side impacts are sickness, spewing, gastro-intestinal dying, melana, peptic ulcer, pancreatitis, uneasiness, laziness, cerebral pain, intemperate thirst, weakness, bradycardia, hypertension, palpitation, chest torment, fruitlessness in female and pneumonic edema.

Pregnancy & Lactation
US FDA Pregnancy category of Ketorolac Tromethamine is C. So, Ketorolac Tromethamine ought to be maintained a strategic distance from in pregnancy and lactation unless the potential benefits to the other exceed the conceivable dangers to the hatchling.

Precautions & Warnings
Caution should be exercised in patients over the age of 65 years. Caution should also be taken in patients with active or suspected peptic ulcer or gastrointestinal bleeding or asthma and liver dysfunction.

Therapeutic Class
Drugs used for Rheumatoid Arthritis, Non-Opioid Analgesics

Storage Conditions
Protect from light and moisture by storing below 30°C. Keep the medicine out of children's reach.