In almost any modern pharmaceutical point of sale, you can buy Ketorol. A medication can be: a gel for external use, tablets for oral use, a substance for injective administration. The medicine is relatively affordable: from 50 rubles, specific figures are determined by the form of release of the drug, the price policy of the point of sale. The manufacturer always puts instructions for use in the package for Ketorol. Before starting the course, it is important to familiarize yourself with the information provided in the accompanying documentation.
general information
The instructions for use of "Ketorol" indicate that the active component on which the action of the drug is based is ketorolac tromethamine (trometamol). First, consider the form for injection. The drug is intended for injection in a muscle or vein. 1 ml contains 30 mg of the active compound. The manufacturer also uses additional components that stabilize the composition and provide shelf life, increased efficiency. The instructions for use of "Ketorol" are listed:
- propylene glycol;
- sodium chloride, hydroxide;
- water for injections;
- ethanol;
- octoxynol;
- disodium edetate.
The solution is placed in small disposable ampoules, has no color, color in a light shade of yellow is allowed. The fluid must be clear.
How it works?
Instructions for use "Ketorol" states that the pharmaceutical product belongs to the class:
- stopping inflammatory processes;
- reducing heat;
- painkillers;
- depressing COX.
The medication belongs to the group of non-hormonal anti-inflammatory drugs (NSAIDs). Efficiency is rated as moderate. The main component of the drug is able to inhibit (inaudible) COX-1, COX-2, which activates the formation of prostaglandins, and therefore enhances pain, fever, foci of inflammation.
Since there is no effect on opioid receptors, the medication is considered relatively safe, regardless of the form of release (gels, tablets, injections). The instructions for use of "Ketorol" noted the lack of influence on the activity of the respiratory system. The drug does not form a dependence, it does not have the qualities of a sedative or anxiolytic effect.
Kinetics
The kinetics of the drug, as stated in the instructions for intramuscular administration of “Ketorol”, does not depend on the frequency of use, remains linear even after a single use, and with repeated administration to muscle tissue or a vein.
When the drug is introduced into the muscle, absolute absorption occurs as soon as possible, with simultaneous use of 30 mg of the active component, the maximum concentration reaches 3.1 μg / ml, with a twice as large dose - up to 5.77 μg / ml. The time required to achieve such indicators for 30 ml is estimated at 73 minutes (or less), for a larger dose - from half an hour to an hour.
When a substance is injected into a vein, the maximum concentration when using a dose of 15 ml is up to 2.98 μg / ml, with a twice as large volume reaches 5.61 μg / ml. The instructions for use for "Ketorol" in ampoules containing a substance for intravenous administration indicate that to achieve maximum concentration with a single use of a dose of 15 ml, it takes up to two minutes, with 30 mg - up to five minutes.
With plasma proteins, the active component binds to 99%. Achieving equilibrium concentration with the introduction of an injection dose of 30 mg four times daily is possible within a day after the start of the course. When stating Ketorol injections intravenously, intramuscularly, the instructions for use oblige patients to take into account the particular state of the patients. In particular, with insufficient functioning of the kidneys, a doubling of the normal values of the distribution volume of the substance is possible.
The nuances of using
The manufacturer indicates the results of studies conducted with the participation of nursing mothers. It was possible to identify that the active substance is able to penetrate into breast milk. When using 10 mg of ketorolac, the maximum values in the product secreted by the glands are achievable after a couple of hours from the moment of using the medication. On average, the concentration is estimated at 7.3 ng / ml after the first dose, after the second - up to 7.9 ng / ml. Instructions for use focus on the “Ketorol” intended for injection: 10% of the active compound passes through the placental barrier.
About half of all substances ingested into the body are transformed when passing through the liver. The reaction products have no pharmacological activity. The predominant volume is glucuronides excreted by the kidneys. Up to 91% of the drug and its transformation products are excreted from the body by the kidneys. The elimination path of the other volume is the intestinal tract.
Instructions for use, reviews of "Ketorol" indicate the effectiveness of the drug when used correctly, as well as the possibility of a negative response from the body, if you do not comply with the manufacturer's restrictions. So, the manufacturer obliges to take into account the features of the functioning of the kidneys, explaining this by the following fact: the half-life of patients whose kidneys function normally varies from 3.5 to 9.2 hours, but in old age a longer time period is possible. The younger the patient, the less time is required for half-life.
Hepatic function does not affect the activity and content of the main component of Ketorol in the patient’s body. In case of impaired renal function and plasma creatinine in an amount of 19-50 mg / l, the half-life of ketorolac is estimated to be 10.3-10.8 hours. If the kidneys function even weaker, this interval exceeds 13.6 hours.
Hemodialysis is ineffective if it is necessary to remove ketorolac from the body.
When will it help?
Severe and moderate pain - indications for which it is recommended to use, following the instructions for use, Ketorol injections. Reviews on the drug prove that the drug shows a pronounced effect if the pain is provoked by the following reasons:
- injury;
- operation;
- oncology;
- rheumatic pathology;
- neuralgia, arthralgia, myalgia;
- toothache;
- radiculitis.
The tool effectively eliminates the symptoms of these diseases, but does not help to correct the cause. The manufacturer pays special attention to the lack of influence from the components of Ketorol on the progress of pathology. With the help of injections, you can only relieve pain, stop inflammation at the time of use.
Strongly impossible!
It is unacceptable to use Ketorol injections (like any other form of release) if intolerance, hypersensitivity to ketorolac or any other substance used by the manufacturer in the manufacture of the medication is detected.
The list of contraindications includes:
- asthma, accompanied by polyps in the nose, in the sinuses near the nose;
- intolerance to acetylsalicylic acid, other non-hormonal anti-inflammatory drugs;
- ulcer, erosion in the digestive tract;
- bleeding in the digestive tract, cerebrovascular, as well as in other areas of the body;
- inflammatory processes in the intestinal tract;
- clotting problems;
- failure of the heart muscle in decompensated form;
- active liver disease or inadequate functioning of this body;
- severe renal failure, progressive pathologies of this organ;
- increased concentration of potassium in the body;
- recent coronary artery bypass grafting;
- combination with certain medications (depressing COX-2, anticoagulants, lithium salts);
- the use of painkillers before surgery or during the intervention (the risk of bleeding increases);
- carrying and breastfeeding a child;
- under 16 years old.
Possible but neat
The manufacturer indicates the possibility of using the drug "Ketorol" only if it is possible to monitor the patient's condition, if the latter is described in one of the following cases:
- asthma;
- ischemia;
- swelling
- high blood pressure;
- hyper-, dyslipidemia;
- creatinine clearance in the range of 30-60 ml per minute;
- diabetes;
- blood poisoning;
- age over 65 years;
- the use of antidepressants from the SSRI group;
- the use of hormonal anti-inflammatory tablets;
- the use of antiplatelet agents;
- severe somatic pathologies;
- smoking;
- gastrointestinal ulcer in the medical history.
- lupus erythematosus;
- cholestasis;
- alcoholism.
Negative consequences
Possible side effects recorded when using "Ketorol" by patients:
- violation of the stool;
- increased gas formation;
- pain in the abdomen, lower back;
- blood components in urine;
- renal failure in acute form;
- ringing in the ears and impaired hearing ability;
- bronchospasm;
- impaired vision;
- runny nose;
- swelling of the larynx;
- sore and dizzy;
- meningitis;
- increase in pressure;
- fainting;
- anemia;
- allergic skin reactions;
- anaphylaxis;
- soreness, burning at the injection site;
- increased sweating.
In some cases, other individual negative responses of the body are possible. The doctor will definitely warn about the possibility of adverse reactions by prescribing the drug. The doctor will tell you how to behave if the body reacts negatively to the medication, in which cases urgent cancellation is necessary.
Drug compatibility
According to the instructions for use, Ketorol and paracetamol tablets can be used in the complex for no more than two days.
It is recommended to avoid combination with other non-hormonal anti-inflammatory drugs, as well as Pentoxifylline, Probenecid. When combined with methotrexate-containing drugs, Ketorol can cause an increased toxic effect on the circulatory system and kidneys. The combination with paracetamol increases the negative effect on the renal system.
Ketorolac and methotrexate in the complex are used only with a minimum dosage of the latter. The patient will have to donate blood regularly to monitor the concentration of this substance in the plasma component. Methotrexate clearance may decrease under the influence of ketorolac. A similar effect is observed with a combination of the described medication and lithium.
As the instructions for use draws attention to, “Ketorol” (and tablets, injections that have a negative effect on blood coagulation) can, in combination, cause bleeding. This forces an extremely careful combination of injections and drugs containing:
- cefoperazone;
- cefotetan;
- heparin;
- warfarin;
- pentoxifylline.
Similar restrictions are imposed on the combination of ketorolac and antiplatelet agents, thrombolytics.
"Ketorol" allows you to reduce the number of narcotic painkillers. When combined with diuretics, means for lowering pressure, it is taken into account that the effectiveness of these drugs is reduced, since the production of prostaglandins is suppressed by the kidneys.
You can use "Ketorol" in the form of injections and antacids - these substances do not correct absorption.
When using hypoglycemic drugs in tablet form, Ketorol insulin increases their activity.
How to use?
The manufacturer draws attention: "Ketorol" must be used in a minimum dosage that shows the effectiveness. The doctor selects the dose, assessing the intensity of the pain syndrome. If necessary, you can combine the described tool and narcotic painkillers using the second group in minimal amounts.
With a weight of 50 kg or more for a group of patients aged 16-64 years, Ketorol injectively is indicated in an amount of up to 60 mg per procedure. As the instructions for use draw attention to, Ketorol tablets and injections can be used simultaneously, in which case a single dose takes into account all forms of use. The classic format of the course is 30 mg with six-hour breaks between treatments. A substance of 30 mg can be injected into a vein, no more than six procedures in two days.
With a weight of less than 50 kg, Ketorol adult patients are injected into muscle tissue, given that a single dose should be within 30 mg (tablets are taken into account if the patient takes those). More often, the drug is used in doses of 15 mg, after two days, the drug is administered no more than eight times. Between the procedures, it is recommended to withstand six-hour intervals.
The maximum amount of ketorolac per day for a patient whose weight is more than 50 kg, and age - between 16-64 years - 90 mg for 24 hours. With less body weight, in old age, with insufficient functioning of the kidneys, the maximum dose per day is 60 mg of ketorolac. Duration of use is two days or less.
The duration of intravenous administration is 15 seconds or more. In the muscle, the drug must be administered deeply, slowly. The primary effect is observed half an hour after the injection, the maximum - after an hour or two. Anesthesia lasts up to six hours (sometimes four or a little more).
Instructions for use: Ketorol gel
For external use, an anti-inflammatory agent is available in the form of a drug, 2% consisting of ketorolac. The substance is transparent, uniform, has a specific smell, has a strong analgesic effect.
As in the case of parenteral administration, local use inhibits the activity of COX-1, COX-2, which means that prostaglandins are formed in a smaller volume, affecting the pain syndrome. Local application allows you to reduce or completely stop the pain at the point of application. Instructions for use ointment "Ketorol" is recommended for joint pain. The effectiveness of the drug has been proven and, if necessary, eliminate pain in the fixed joint, and while relieving the condition of the moving part. In the morning, the Ketorol gel allows you to remove the stiffness of movements, eliminates swelling of the joint areas. Patients using this tool can allow themselves to move more actively, more, which means improving the quality of life.
When will it help?
Severe pain is the main indication mentioned in the instructions for use of the Ketorol gel. Reviews of the tool confirm its effectiveness if necessary, to alleviate the condition of the patient who has suffered an injury, as well as the patient:
- myalgia;
- arthralgia;
- osteoarthrosis;
- neuralgia;
- rheumatism;
- sciatica.
The gel eliminates the pain syndrome, relieves one of the main symptoms of the pathological condition, but does not affect its root cause. "Ketorol" does not prevent the disease from progressing, but prevents the development of inflammatory processes. It shows a pronounced effect at the time of application, does not have cumulative qualities.
Application rules
The gel is intended for outdoor use. Before application, skin areas are cleaned with water, dried, squeezed a strip of the drug (up to 2 cm long) in the area where the pain is most severe. The drug is distributed in soft movements, similar to massage. A day you can use the medication up to 4 times. The amount of gel for each time, the repetition rate will be indicated by the doctor, focusing on the strength of the pain, the body's response to the medication, the area of the treatment area.
Ketorol gel is intended for use for no more than 10 days in a row. If you need longer use, you will first need to consult your doctor.
Negative consequences
The gel may cause itchy skin areas. In some patients, under the influence of ketorolac, the skin begins to peel off. Possible urticaria. If there is a negative answer, they do not use the drug, they go to the doctor to choose a replacement. When processing large areas, there is a risk of negative systemic reactions of the body. Nausea and vomiting, pain in the stomach and stool were occasionally noted. Perhaps the appearance of ulcers on the mucous membranes of the stomach and intestines. Occasionally, patients were sick and dizzy, there was a tendency to edema, an allergic response of the body.
How to replace?
Instructions for the use of "Ketorol" will help when choosing analogues, indicating that the active component of the drug is ketorolac. The following tools are based on it:
As follows from their instructions for use, the Ketorol gel analogues are based on ketorolac, but the rules for use are somewhat different from the anti-inflammatory ointment: medicines are available in the form of tablets or substances for injectable use.
If you need to choose an alternative remedy for topical use, consult your doctor. The doctor will pick up a gel or ointment on another active substance, but also with anti-inflammatory and analgesic effects.
Ketorol for oral administration
In addition to release for injective administration and local application, the drug is made in tablet form. Instructions for use of tablets "Ketorol" recommends resorting to a tool if:
- I have a toothache;
- injury, sprain, dislocation;
- surgery, childbirth;
- oncological disease is established.
Ketorol tablets are taken for rheumatism, pain in muscles, joints, with radiculitis and neuralgia.
The tool is used only to relieve symptoms. For example, taking the Ketorol tablets from toothache according to the instructions for use, you can only alleviate the manifestations, but you will not be able to eliminate the cause of the disturbing sensations. The drug does not affect the progress of the disease. Its main purpose is to eliminate inflammatory processes and reduce soreness.
It is impossible!
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Terms of use
A single dosage is 10 mg of the active ingredient. The tablets are used orally. If the pain is severe, you can use the drug up to four times during the day. The specific frequency and dose is selected based on the characteristics of the patient's condition. Do not use more than 40 mg of ketorolac per day. The duration of the treatment program is up to five days.
If Ketorol was initially used in the form of injections, when switching to tablets, the amount of the drug received by the patient on the day of the transition between forms should be controlled: at the age of under 65 years old, the volumes should be within 90 mg, for older people - 60 mg. Of this amount, tablets should be no more than 30 mg.
In case of an overdose, the abdomen may hurt, ulcers and erosion in the stomach or intestinal stroke, acidosis and impaired renal activity may occur. The patient is shown gastric lavage, the use of activated charcoal and therapy, which allows maintaining vital functions based on the symptoms of a particular case. Studies have shown that dialysis does not allow the active compound to be eliminated from the body, therefore, an overdose procedure is not recommended.