Ketorolac Tromethamine (Toradol)

Toradol is not available in U.S, but the generic brand may still be available.  Ketorolac Tromethamine is in a member of nonsteroidal anti-inflammatory drugs (NSAIDs) indicated for severe acute pain in adults up to five days as a continuation therapy to IV or IM dosing. To minimize the potential risk for adverse reaction, use the lowest effective dose with the shortest duration.

When not to use (contraindication) Ketorolac Tromethamine:
  1. Do not use Ketorolac Tromethamine oral formulation as an initial dose
  2. Patients with heart disease
  3. Do not use in patients younger than 17 years
  4. Mild or chronic pain
  5. Patients with peptic ulcers or history of peptic ulcers and gastrointestinal bleeding  
  6. Patients with recent gastrointestinal bleeding or perforation
  7. Patients with renal impairment or at risk of renal failure
  8. Nursing mother
  9. Do not prescribe to patients who are currently taking aspirin or NSAIDs
  10. Do not use Ketorolac Tromethamine during labor or delivery due to the effect on fetus circulation
  11. As a prophylactic analgesic before surgery
  12. Suspected or confirmed Patient with cerebrovascular bleeding
  13. Pain reliever after coronary artery bypass graft (CABG) surgery
  14. Do not use Ketorolac Tromethamine more than five days
  15. Do not exceed daily maximum dose of 40 mg
Active ingredient in a tablet contains 10 mg Ketorolac Tromethamine
Inactive ingredients:
  • Lactose, Magnesium stearate
  • Microcrystalline cellulose
  • Hydroxypropyl methylcellulose
  • Polyethylene glycol
  • Titanium dioxide

Drug interactions: Patients should not take Ketorolac Tromethamine with the following medications:
  • Aspirin
  • Diuretics, e.g., Furosemide, Thiazides
  • Probenecid
  • Lithium
  • Metrotrexate
  • Angiotensin receptor blockers or ACE inhibitors (drugs for treatment of the kidney damaged due to diabetes, high blood pressure, congestive heart failure)
  • Antiepileptic drugs (Ketorolac tromethamine, Phenytoin, Carbamazepine)
  • Psychoactive drugs (Fluoxetine, Thiothixene, Alprazolam
  • Pentoxifylline

Side effect:
  1. Abdominal pain, Gastric and duodenal ulcers
  2. Tachycardia, syncope, hypotension, chest pain, myocardial infarction
  3. Stool is black or bloody
  4. Cough up blood
  5. Ecchymosis (skin discoloration as in a bruise)
  6. Swelling (Angioedema), rapid weight gain
  7. Mouth sores
  8. Constipation/diarrhea
  9. Flatulence (excessive gas)
  10. Nausea, vomiting, sweating
  11. Abnormal renal function
  12. Drowsiness, vertigo
  13. Headaches, fever, sore throat
  14. Anemia
  15. Laryngeal edema, tongue edema
  16. Hypertension
  17. Itching (Pruritus)
  18. Ringing in the ears (Tinnitus)
  19. Increased bleeding time 
  20. Fever, sepsis
  21. Congestive heart failure
  22. Palpitation
  23. Photosensitivity (sensitivity to light)
  24. Urticaria (itchy red or white raised patch on the skin)
  25. Anorexia (loss of appetite, inability to eat)
  26. Dry mouth
  27. Jaundice
  28. Insomnia (difficulty in falling or staying asleep)
  29. Malaise
  30. Paresthesia
  31. blurred vision
  32. Increased urinary frequency
  33. Aseptic meningitis
  34. Convulsions, coma, psychosis
  35. Respiratory depression, pneumonia

Before taking this pharmaceutical, consider the potential benefits and risks to other alternative options.

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