"Ketorolac" (injections): instructions for use, indications, composition, analogues, reviews

• October 8, 2018
• Traumatology and surgery
• Smirnova Alexandra

In the article we will look at the instructions for use for Ketorolac injections. This is a medicine with analgesic, anti-inflammatory and antipyretic effects from the largest Russian pharmaceutical company. Many people are interested in what the composition of Ketorolac injections is. Let's take a closer look at this issue.

Possible side effects

Side effects to Ketorolac injections, the use of which was described above, are also quite varied and can occur from a variety of body systems.
The gastrointestinal tract can most often respond with the development of diarrhea and the appearance of symptoms of gastralgia. Less often you can hear about constipation, vomiting, flatulence, and the development of ulcerative lesions. The urinary system reacts to Ketorolac quite rarely, however, here you can hear about hematuria, lower back pain, nephritis and edema of renal origin.

Also, quite rarely, in response to injections, the respiratory organs (bronchospasm, rhinitis, edema of the lungs and larynx) and sensory organs (visual impairment, deterioration of auditory perception, ringing in the ears) manifest themselves.

Patients often talk about the reaction of the central nervous system to Ketorolac, manifested by drowsiness, dizziness, and headaches. Less often you can hear about the symptoms of aseptic meningitis and hyperactivity, the appearance of psychoses and hallucinations.

From time to time, information appears about undesirable manifestations from the cardiovascular system (increased blood pressure), the hematopoietic system (leukopenia, anemia), and the hemostasis system (bleeding - nasal, rectal, postoperative).

Patients often report swelling of the face, legs, ankles, fingers, weight gain, and increased sweating.

How long can you inject Ketorol?

According to the instructions, the maximum course of use is limited - injections are allowed for no more than 5 days. If pain relief is required longer, it is recommended to replace Ketorol injections with drugs of a similar effect. You need to start with the minimum therapeutic dose - 10-15 mg.

You can inject several times a day, dividing the maximum dose (60-90 mg) and maintaining an interval of 4-6 hours, or inject once a day if the dosage is small. Long-term use of the drug increases the risk of side effects.

Side effect

If the dosage or duration of use is violated, side effects may occur:

Side effects may be due to age-related changes in the body's condition, systemic and autoimmune diseases.

Interaction with other drugs

Ketorol (injections) is not recommended to be combined with other NSAIDs and:

• ethyl alcohol;
• glucocorticoids;
• some groups of antibiotics;
• anticoagulants and thrombolytics;
• Tramadol;
• lithium preparations.

The simultaneous use of Ketorol and opioid analgesics, insulin requires a reduction in the administered dose of the latter.

Use during pregnancy and lactation

The drug should not be used by pregnant and lactating women, since the active substance can penetrate (albeit in small quantities) through the placental barrier, and traces of it are found in human milk.

Pharmacological properties and pharmacokinetics

Ketorol is an anti-inflammatory drug (NSAID) that does not have a sedative or hypnotic effect and does not cause addiction or breathing problems, unlike opiate drugs.

The medication has several effects at once:

• reduces temperature;
• stops pain;
• reduces the focus of inflammation.

Its analgesic effect is due to the ability to inhibit lipid physiological substances (prostaglandins), which are located in all tissues of the body and are responsible for the sensitivity of nerve endings. Thanks to these substances, pain and inflammatory processes in the body are modulated, which stop under the influence of Ketorol.

The injection form of the drug ensures almost instantaneous entry into the bloodstream, where it is completely absorbed and provides pain relief:

• when administered intramuscularly after half an hour;
• with intravenous injection – after 10 minutes.

The maximum effect occurs 1-2 hours after the injection, and its therapeutic effect lasts for 5 hours. The drug is metabolized in the liver, breaking down into simple components - glucuronides, which are completely excreted after 10-15 hours along with urine and feces.

Therapeutic properties of the drug Ketorol

The instructions for use do not indicate analogues for the drug "Ketorol".
Doctors select them based on the therapeutic properties of the drug. The drug “Ketorol” has the same properties: the drug has a triple effect on the human body - it anesthetizes, relieves inflammation and lowers temperature, and at the same time, this must be kept in mind when choosing an analogue for the medicine. “Ketorol” still stands out to a greater extent for its pain relief function. This drug blocks the enzyme cyclooxygenase. It is this element in the human body that is responsible for the formation of substances that cause pain, inflammation and fever. After blocking it, the production of these substances stops, so the person stops feeling pain.

This drug does not cause respiratory depression, does not increase blood pressure, does not affect kidney function, does not cause intestinal colic, and does not act on the central nervous system as a drug.

The analgesic Ketorol can thin the blood, so it is not suitable for patients with hemophilia and stomach ulcers.

The above properties apply to all forms of the drug "Ketorol".

Instructions for use

In order for the drug to be safe and effective, you should follow the instructions for its use. The method of use depends on the dosage form of the drug.

The dosage of Ketorol is selected by the attending physician; you should not independently change the frequency, dose and duration of use of the medicine. This can lead to complications from various organs.

The following will provide instructions for the use of Ketorol in various dosage forms. The information is for informational purposes only; first of all, follow the doctor’s prescriptions.

Pills

The frequency of taking Ketorol tablets depends on the severity of the pain syndrome. The maximum amount of the product is 4 tablets per day. It is necessary to use the minimum possible dose of medication that can relieve the symptoms of the disease. This is the only way to reduce the likelihood of side effects.

A medication prescription regimen is often used, in which Ketorol injections are first administered intramuscularly or intravenously, and then replaced with tablets. In this case, the permissible dose increases. It depends on the age of the patients and is selected individually by the attending physician.

Injections

The injection form (Ketorol in ampoules) is used on the same principle as tablets with the drug Ketorol; injections should contain the minimum possible dose of the drug. The product can be used intravenously and intramuscularly.

In this case, the solution is prepared depending on the age and body weight of the patient.

When the drug is administered intramuscularly, a slow injection is performed so that the drug is gradually distributed in the muscle layer. Repeat the procedure every 6 hours.

Intravenous injections are performed with the same frequency, no more than 15 injections per 5 days of using the drug.

Regardless of whether the medicine is used intramuscularly or intravenously, the course of treatment should not exceed five days. To reduce the dosage of the drug, small doses of narcotic analgesics can additionally be used.

Gel

The external form of the drug - a gel - is used to treat localized pain syndrome.

Instructions for use of the medicine contain the following steps:

• Wash with soap and dry the surface of the skin where the medicine is applied.
• Apply a small amount of product 2 cm long to the surface of the skin.
• Lightly spread the gel around the affected joint.
• Allow the drug to absorb for several minutes.
• Repeat the procedure up to 4 times a day, at intervals of more than 4 hours.
• The course of treatment lasts up to 10 days.

It is prohibited to exceed the dosage and duration of use of the gel. If symptoms of the disease persist, you should consult a doctor to adjust your prescription.

Candles

Very often there is a need to use non-steroidal drugs in the form of rectal suppositories. This form combines the effectiveness of systemic medications and the safety of local use.

Unfortunately, suppositories with the trade name Ketorol are not represented on the modern pharmaceutical market. If you need to use the active ingredient ketorolac in this form, you should consult a doctor.

The specialist will select suppositories with a non-steroidal drug, similar in effect to Ketorol.

Nuances of use

The manufacturer indicates the results of studies conducted with the participation of nursing mothers. It was possible to reveal that the active substance is able to penetrate into mother's milk. When using 10 mg of ketorolac, the maximum levels in the product secreted by the glands are achievable within 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

For Ketorol intended for injection, the instructions for use emphasize: 10% of the active compound passes through the placental barrier

About half of all substances entering the body are transformed when passing through the liver. The reaction products have no pharmacological activity. The predominant volume consists of glucuronides excreted by the kidneys. Up to 91% of the drug and its transformation products are excreted from the body by the kidneys. The route of elimination of other volume is the intestinal tract.

Instructions for use, reviews of Ketorol indicate the effectiveness of the product when used correctly, as well as the possibility of a negative response from the body if the restrictions set by the manufacturer are not followed. Thus, the manufacturer obliges to take into account the peculiarities of the functioning of the kidneys, explaining this by the following fact: the half-life in 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.

Liver function does not affect the activity and content of the main component of Ketorol in the patient’s body. If renal function is impaired and plasma creatinine levels are 19-50 mg/l, the half-life of ketorolac is estimated at 10.3-10.8 hours. If the kidneys function even weaker, this period exceeds 13.6 hours.

Hemodialysis is ineffective when it is necessary to remove ketorolac from the body.

Adverse reactions

Violation of the instructions will certainly lead to the development of complications from internal organs, since the drug is potent. The first symptom will be headache, severe dizziness with a sudden change in body position, weakness, fatigue, drowsiness or insomnia, disturbance of psycho-emotional state, depression.

In patients with pathologies of blood vessels and the heart, tachycardia, pain in the heart region, arrhythmia, angina attacks, and increased blood pressure to critical levels are observed. As a rule, such symptoms become a reaction to incorrectly selected dosages of antihypertensive and antiarrhythmic drugs.

There are also disturbances from the gastrointestinal tract: nausea, exacerbation of chronic diseases, bouts of vomiting, heaviness in the stomach after eating, decreased appetite, heartburn, flatulence, bloating, persistent constipation or frequent loose stools.

In case of overdose, all symptoms worsen, the patient's condition worsens, vision may be impaired, convulsions, severe muscle pain, and aches throughout the body are observed. In severe cases, consciousness may be impaired, but such signs appear very rarely.

An allergy to a drug manifests itself suddenly or gradually and without severe symptoms. In the first case, the patient develops acute urticaria or Quincke's edema. In the second, a rash of different shapes and sizes appears, itching, irritation, peeling, hyperemia, dry skin.

What to pay attention to

Before starting treatment with Ketorolac, it is important to find out whether there have been previously recorded cases of allergic manifestations to the medication or other NSAIDs. It is advisable to carry out the first injection in the presence of a doctor (to avoid allergies)

If such a need arises, you can use Ketorolac (injections) in combination with narcotic analgesics. For patients suffering from blood clotting disorders, Ketorolac is prescribed for use only with the condition of constant monitoring of the platelet count. This is a particularly pressing issue for people who have undergone surgery and require careful monitoring of hemostasis.

In people with chronic diseases and pain, increasing the period of therapy can cause the development of drug complications.

During treatment with Ketorolac, it is important to be careful when driving and avoid potentially dangerous types of work associated with increased attention and increased speed of psychomotor reactions.

By-effect

During studies of the drug, a number of side effects were identified.

Gastrointestinal tract:

• To eliminate problems, it is recommended to perform gastric lavage

constipation or diarrhea;

feeling of heaviness in the stomach; vomit; the formation of erosions, ulcers on the walls of the stomach or intestines, bleeding; hepatitis; acute pancreatitis; jaundice (static type chole); hematomegaly (extremely rare); heartburn.

Respiratory system:

• dyspnea;
• rhinitis;
• bronchospasm;
• swelling in the throat area.

CNS:

• lack of coordination;
• physical weakness;
• headache;
• increased tone of the back/neck muscles (strong resistance to bending and motor function of the body);
• altered psycho-emotional background (mood swings, hyperactivity, abruptly giving way to apathy);
• problems of various types with hearing, vision;
• hallucinations.

Genitourinary system:

• pain in the lumbar girdle (may be accompanied by azotemia, hematuria);
• kidney dysfunction;
• change in the volume of urine produced, frequent urge to urinate;
• swelling associated with kidney dysfunction;
• nephritis (extremely rare).

Blood-forming organs:

• decrease in the number of leukocytes (extremely rare);
• increased number of eosinophils in the blood;
• anemia.

The cardiovascular system:

• blood pressure surges;
• loss of consciousness;
• pulmonary edema.

Allergy to the components of the drug: anaphylaxis or anaphylactoid symptoms.

An overdose of Ketorol is possible.

It can be recognized by the following signs:

• nausea;
• vomiting;
• pain in the abdominal cavity;
• peptic ulcers;
• damage to the walls of the esophagus, stomach, intestines;
• accumulation of acids in the body as a result of their excessive production or consumption;
• kidney dysfunction.

To eliminate problems, it is recommended to perform gastric lavage. This must be done no later than two hours after the Ketorol injection. It is also necessary to take adsorbent drugs and agents that relieve symptomatic manifestations.

General information about the drug

Ketorol is an anesthetic that has an anti-inflammatory and moderate antipyretic effect on the body. The active substances of the drug block the transmission of nerve impulses to the brain, thereby freeing a person from suffering. Pain signals do not reach the brain, and it does not inform the patient about the presence of pain in the body.

Does ketorol help with toothache? This drug is prescribed to patients in the postoperative period; today it is one of the strong painkillers available to people at an inexpensive price. The medicine is sold without a prescription and is available in every pharmacy. Read the instructions carefully before use.

The drug does not cause adverse side effects like drugs and is completely safe. It does not increase blood pressure, does not interfere with urinary functions, does not depress the respiratory process, does not weaken the functionality of the intestines and does not affect the nerves.

Composition of the drug

The active medicinal substance in the drug is ketorolac, which has a pronounced analgesic effect. The composition also includes lactose. However, the disappearance of pain does not mean healing from the disease: the patient should immediately make an appointment with a dentist. Severe pain indicates pathological changes in bone/gingival tissue and requires immediate treatment.

If the patient does not respond to changes in health, pathological processes in the tissues will eventually lead to the destruction and loss of the diseased tooth. The disappearance of pain impulses does not indicate healing of the disease.

The drug is not classified as a narcotic and does not cause addiction; there are also no side effects noted after using the drug. However, it is not recommended to abuse the drug, as well as to combine it with analgesics. Before use, discuss all the details with your doctor.

Method of use and dosage regimen

The pharmacological drug “Ketorolac” in solution is administered intravenously (in a stream) in a slow flow (at least 15 seconds) or deep intramuscularly in the minimum effective dosage, which is selected by a specialist depending on the severity of the pain syndrome and the patient’s response. If necessary, simultaneous use with opioid analgesics in reduced dosages is permitted.

Depending on the severity of the pain syndrome, a single adult dosage (intramuscular or intravenous) ranges from 10 to 30 mg. Patients over 65 years of age or with changes in kidney function are usually prescribed 10-15 mg.

When repeatedly administering parenterally the drug “Ketorolac” in ampoules, the following dosing rules apply:

1. Intramuscular administration: for patients under 65 years of age and after 16 years of age - 10-60 mg at the first injection, then - at intervals of 6 hours, 10-30 mg; for elderly patients (after 65 years) or for impaired renal activity - 10-15 mg every 6 hours.
2. Intravenous administration: for patients under 65 years of age and over 16 years of age - 10-30 mg for the first injection, in a stream, subsequently - 10-30 mg every 6 hours, the initial dosage for continuous infusion using an infusion pump - 30 mg, after which the rate infusion should be 5 mg per hour; for elderly patients (after 65 years) or for kidney disorders - every 6 hours, 10-15 mg as a bolus.

The maximum daily dosage of Ketorolac injections for intravenous and intramuscular administration is:

• under 65 years of age and children over 16 years of age – 90 mg;
• elderly patients (after 65 years) or with impaired renal function - 60 mg.

Continuous intravenous administration should not last more than 24 hours. The duration of the course is no more than 5 days. When transferring a patient from intravenous and intramuscular administration to taking the drug Ketorolac orally, the total daily dosage per day should not exceed that administered by injection.

Contraindications for use

Patients who have known hypersensitivity to any of the components should not use the drug for treatment. The basis for refusal is also the presence of the “aspirin triad” and hypovolemia (the reason that provoked the disease is not important). Also, “Ketorolac” (injections and tablets) is not prescribed to those who have any erosive and ulcerative lesions of the gastrointestinal tract in the acute stage.

Those who suffer from hemophilia, hypocoagulation and are susceptible to bleeding or are at high risk of developing it should not use these injections for treatment.

Also a contraindication is the presence of severe forms of renal and liver failure.

Ketorolac is not prescribed for use immediately after coronary artery bypass surgery, during the 3rd trimester of pregnancy, during childbirth and lactation. Injections are contraindicated for children under 16 years of age.

Description of the drug and dosage dosage

Ketorol is a non-steroidal anti-inflammatory drug with a strong analgesic effect. The active ingredient is ketorolac tromethamine or ketorolac. The drug has antipyretic, analgesic and anti-inflammatory properties. Ketorolac by its action inhibits the formation of prostaglandins, which play an important role in inflammatory and pain processes. The substance does not inhibit the functioning of the respiratory center, does not have a negative effect on opioid receptors, does not have an antidepressant or sedative effect, and is not addictive. Ketorol's analgesic effect is similar to morphine and is largely superior to NSAIDs of other groups. The analgesic effect begins half an hour after intramuscular injection and an hour after administration. The greatest effect is achieved after 1-2 hours.

The composition of the tablets and the drug in ampoules includes tromethamine ketorolac and additional inactive substances.

The main indications for use are blocking pain of varying severity, manifested for any reason, including oncology and postoperative pain.

Release form: tablets, ampoules, suppositories (suppositories), ointment, gel.

Mode of application:

1. Tablets are prescribed orally once. The dosage depends on the severity and intensity of the pain. If necessary, the dose is repeated, but without exceeding the maximum allowable dose of 4 tablets per day, i.e. 40 mg. You should not take the drug for more than five days in a row.
2. Injections are administered intramuscularly. The dosage is prescribed individually depending on the intensity of pain. If necessary, the amount of the administered drug is adjusted. It is allowed to take opioid analgesics in reduced doses in parallel. The maximum dose for intramuscular injections is 90 mg per day for patients under 65 years of age, a single injection is given in a volume of 10-30 mg. After the age of 65 years, the dosage of Ketorol should be reduced to 10-15 mg at a time, and the maximum possible dose should be no more than 69 mg per day, especially in cases of renal impairment. The medication is administered for no longer than five days.
3. Ointment and gel are used to relieve pain in post-traumatic inflammation of muscles, ligaments, and joints. For soft tissue injuries, sprains, dislocations, bursitis, tendonitis, epicondylitis, inflammation of the synovial membrane, osteoarthritis of the superficial joints.

In some cases, it is necessary to switch from intramuscular injections to oral administration of the drug in tablets. In this case, the maximum permissible dose of the drug should also be observed. The total daily dose of the drug in any form of release is no more than 90 mg per day for people under 65 years of age, and 60 mg per day for people over 65 years of age.

Cost of the drug, analogues

Ketorol tablets and solution are dispensed only upon presentation of a prescription. The gel is sold freely and should be used according to the principle of responsible self-medication. Ketorol is stored in a dry, dark place at room temperature (not higher than 25 degrees). Provided the original packaging is intact, the pharmacological properties are not lost for: gel - 2 years, tablets, solution - 3 years.

Ketorol can be purchased in pharmacies at the following prices:

• tablets 0.01 20 pcs. – 50 rub.;
• solution 0.03/ml 10 ampoules – 94 rubles;
• gel 2% tube 30 g – 260 rub., 50 g – 370 rub.

Ketorol can be replaced with non-steroidal drugs based on Ketorolac or another active substance.

The closest analogues are:

• tablets and solution Ketorolac, Dolak, Ketanov;
• tablets Ketofril, Ketocam;
• solution Dolomin, Vatorlak.

All medications containing Ketorolac are characterized by a powerful analgesic effect. To avoid undesirable consequences, they should be used only in exceptional cases and strictly in accordance with the instructions.

Indications

The purpose of the drug is exclusively symptomatic treatment. This means that Ketorol does not affect the direct cause of pathological processes in the body.

The drug is prescribed for various pain syndromes:

• toothache;
• muscle pain (myalgia);
• inflammation of the nerves (neuralgia);
• radiculitis;
• headaches and migraines;
• joint pain (inflammation of the joints with arthritis or destructive processes in the joints with arthrosis);
• painful menstruation;
• conditions after operations and childbirth;
• sprains, injuries and dislocations;
• rheumatism.

The drug can also be used for pain caused by cancer. It should be remembered that ketorolac is not recommended for use for chronic pain.

Ketorolac can affect pain of both moderate and high intensity. For relatively minor pain, it is recommended to use other NSAIDs. For pain associated with skin tissues and muscles, in most cases it will be more effective to use not the injectable form of Ketorol, but the external form of the drug - a gel.

Despite the fact that the drug is often used to relieve postoperative pain, it should not be used during or before major surgical interventions. The same applies to the possible use of the drug for pain relief during childbirth. This is strictly prohibited. These prohibitions are associated with the risk of massive bleeding.

Indications for use

The drug is prescribed for pain syndromes of severe and moderate severity, including toothache, trauma, postoperative pain; pain syndrome in oncological diseases, myalgia, neuralgia, arthralgia, radiculitis, rheumatic diseases, sprains, dislocations.

Not everyone knows what Ketorolac injections help with.

The medication has no effect on the progression of the pathological process. This medication should be used only for symptomatic therapy, to reduce the severity of the inflammatory process and pain at the time of use.

Instructions for use of ampoules

Ketorol should be used for injection into a muscle or vein. The product is not suitable for spinal and epidural injections.

The number of injections per day, as a rule, does not exceed 2 times. This is due to the effectiveness of the product and its long-lasting effect.

It is allowed to use Ketorol for 5 days.

Corrections regarding the duration of the course and the addition of therapy with other means are carried out exclusively by a specialist.

Instructions on how to prick:

• An intramuscular injection is made with deep penetration into the muscle tissue. The product should be released slowly. The pharmacological effect declared by the manufacturer occurs after half an hour and lasts up to 6 hours. 1-2 hours after the injection, the peak analgesic effect is observed. A single dose per adult is 1-3 ampoules. For long-term treatment, the first dose can be 30 mg, subsequent doses are reduced to 10-15 mg.
• Intravenous administration of the drug is also carried out slowly with a solution release rate of 15 s/1 ml. Before the procedure, a clearly visible vein is selected (usually in the arms or in the chest area). The puncture site is treated with an antiseptic before and after administering the solution. It is not allowed to administer simultaneously with other drugs (put in the same syringe).

How to apply Ketorol correctly

First of all, the area of ​​the body to which the gel will be applied is thoroughly washed with soap and water, wiped dry and then 1-2 cm of cream is squeezed out of the tube, spreading it with your hands in an even layer over the skin. Of course, if the area being treated is large, the amount of cream increases accordingly.

The drug is rubbed in with light, massaging movements until the gel is completely absorbed, and a bandage of gauze or bandage can be applied over the treated area, so that the skin can breathe or leaving it open. Speaking about the frequency of treatment of the skin area, the gel is applied up to 4 times a day, with an interval of 4 hours between procedures - the course of applying the gel is no more than 10 days. If the pain does not go away, after this period and before using Ketorol, you should first consult with doctors.

Adverse reactions

Tablets and injections have a direct effect on the patient’s psychomotor state. If the drug in gel form gets into the stomach, it is recommended to induce vomiting and drink the sorbent. In case of an overdose of solution or tablets, the following negative signs appear:

• abdominal pain;
• vomiting with nausea;
• development of ulcers with erosive gastritis;
• renal dysfunction;
• acidosis.

Therapy for overdose consists of removing the active component from the body. For this, gastric lavage is indicated. After taking the sorbent, symptomatic therapy is prescribed. Its goal is to support the functions of vital systems and organs.

Complex therapy with NSAIDs and glucocorticosteroids increases the risk of developing ulcers in the gastrointestinal tract. Ketorol and medications containing gold compounds disrupt kidney function. Similar problems develop when Methotrexate is combined with ketorolac. With this regimen, the dose of the first medication is reduced.

The drug in question increases the level of lithium drugs in the blood. If you include Ketorol in the regimen, the dosage of the narcotic pain reliever is reduced. This has a positive effect on the general well-being of the patient. While taking ketorolac, the effect of insulin increases, but the degree of diuretic effect of Furosemide decreases to 20%.

Combined use of Ketorol with the following medications provokes negative effects:

1. Valproates: platelet aggregation is impaired, bleeding develops.
2. Non-depolarizing muscle relaxants: shortness of breath appears during therapy.
3. Anti-epileptic drugs: often a manifestation of an epileptic seizure.
4. Antidepressants: the patient is bothered by hallucinations.
5. Thrombolytics: Increase the likelihood of bleeding.

Possible, but carefully

The manufacturer indicates the possibility of using the drug "Ketorol" only if it is possible to control 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 within 30-60 ml per minute;
• diabetes;
• blood poisoning;
• age over 65 years;
• use of SSRI antidepressants;
• use of hormonal anti-inflammatory tablets;
• use of antiplatelet drugs;
• severe somatic pathologies;
• smoking;
• gastrointestinal ulcer in medical history.
• lupus erythematosus;
• cholestasis;
• alcoholism.

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Features of use

You can buy the medicine only if the patient has a prescription for Ketorol in ampoules. Free distribution of the drug from pharmaceutical points of sale is prohibited, since improper use can cause severe negative consequences.

"Ketorol" is prescribed if the patient is bothered by pain assessed as moderate or high level. The drug is effective for pain syndromes of various origins. It is prescribed during the rehabilitation period after surgery. The indications for the use of Ketorol in ampoules are oncological diseases accompanied by severe pain. You can use non-steroidal anti-inflammatory drugs only after prior consultation with your doctor.

It is important to administer the substance correctly, otherwise there is a risk of local damage

Sometimes patients ask, when using Ketorol in ampoules, can they drink alcoholic beverages or is it prohibited?

The manufacturer of the product points out that the combination of medication and alcohol is strictly not recommended.

Side effects

Ketorol is a very effective drug that can reliably block pain. However, the power of the drug also has a negative side - a fairly large number of side effects.

The most common side effects experienced by a significant number of patients, more than 1%, are swelling of the limbs and face, dizziness, drowsiness and headache. For the latter reason, the drug is not recommended for people driving vehicles or doing work that requires concentration.

Also quite common side effects, observed in more than 1 patient out of 100, are stomach upsets, abdominal pain, and diarrhea. These symptoms most often occur in older people with a history of gastrointestinal ulcers. It should be noted that such side effects are typical not only for the tablet form of the drug. They can also occur in the case of parenteral administration.

Some of the following side effects occur in more than 1 patient in 1000, but less than 1 patient in 100:

• stomatitis,
• flatulence,
• constipation,
• vomit,
• increased blood pressure,
• skin rash and itching,
• pain and burning at the injection site,
• profuse sweating.

Even less common side effects include:

• ulcers of the gastrointestinal tract,
• gastrointestinal bleeding,
• hepatitis,
• cholestatic jaundice,
• dry mouth,
• strong thirst
• acute pancreatitis,
• acute renal failure,
• blood in urine
• frequent urination or lack of urine,
• nephritis,
• hearing loss,
• tinnitus,
• visual impairment,
• bronchospasm,
• rhinitis,
• swelling of the larynx,
• aseptic meningitis,
• hallucinations,
• hyperactivity,
• depression,
• psychosis,
• pulmonary edema,
• fainting,
• bleeding (rectal, nasal, from a postoperative wound),
• anemia,
• eosinophilia,
• leukopenia,
• exfoliative dermatitis,
• hives,
• Stevens-Johnson syndrome,
• Lyell's syndrome,
• anaphylactic shock,
• swelling of the tongue,
• fever.

The drug may adversely affect fertility, so women with reduced fertility or undergoing fertility treatment should avoid taking ketorolac.

What to do if side effects occur

If any side effects occur, especially of the allergic type, you should consult a doctor. Perhaps a reduced dosage will avoid side effects. And some phenomena can go away on their own. However, in many cases, the presence of side effects indicates intolerance to the drug. Then it will be necessary to find a replacement for him.

What can you do to prevent side effects?

Please keep in mind that the likelihood of side effects depends on the dose. This probability increases sharply when the maximum permissible daily dosage of 90 mg is exceeded. However, on the other hand, taking the drug in a minimum dosage cannot guarantee the occurrence of adverse reactions.

Also, the likelihood of side effects increases if the patient has relative contraindications. In such cases, the drug can be taken only as prescribed by a doctor and under his supervision. It is possible that in the above situations, the optimal choice would be another pain reliever and anti-inflammatory drug.

To reduce the risk of gastrointestinal disorders, ulcerations and bleeding from the gastrointestinal tract, proton pump inhibitors (omeprazole) can be used.

Due to the risk of an acute intolerance reaction, the first parenteral administration during the course of treatment should be carried out under the supervision of medical personnel. Thus, treatment with the drug in injection form is best carried out in a hospital setting.

Drug interactions

• When taken with acetylsalicylic acid or other NSAIDs, calcium preparations, corticosteroids, ethanol, corticotropin, it can cause ulcerative lesions of the gastrointestinal tract and the development of gastrointestinal bleeding.
• Increases the effect of other nephrotoxic drugs. Simultaneous administration with paracetamol increases the toxic effect on the kidneys, and with methotrexate - on the kidneys and liver. If simultaneous use with methotrexate is required, the dose of the latter should be reduced.
• Probenecid increases the concentration of drugs in the blood plasma. The use of ketorolac may reduce the clearance of methotrexate and lithium, as well as increase the toxicity of these substances.
• Combination with indirect anticoagulants, heparin, thrombolytics, antiplatelet agents, cefoperazone, cefotetan and pentoxifylline increases the risk of bleeding.
• Reduces the effect of antihypertensive and diuretic drugs.
• While taking drugs, the dose of opioid analgesics can be significantly reduced.
• Strengthens the hypoglycemic effect of insulin and oral hypoglycemic drugs, which requires dose adjustment.
• Combination with valproic acid causes disruption of platelet aggregation. Increases the plasma concentration of verapamil and nifedipine.
• The clearance of ketorolac can be reduced by drugs that block tubular secretion.

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Indications for therapy

Instructions for the use of Ketorol injections and other dosage forms suggest its use only after a thorough examination and identification of the cause of the pathology. Most often the drug is prescribed in the following cases:

• toothache and headache of varying intensity;
• heavy and painful menstruation;
• severe migraines;
• arthritis of psoriatic, rheumatic and gouty etiology;
• acute period of gout with pronounced clinical manifestations;
• exacerbation of chronic pancreatitis;
• severe arthrosis with damage to large articular joints;
• osteochondrosis of different parts of the spinal column, shoulder or hip joint;
• polyarthritis with damage to the joints of the hands and feet;
• chronic radiculitis with frequent exacerbations and irradiation of pain to the lower extremities;
• displacement of the vertebrae and pinched nerve endings;
• severe intervertebral hernia;
• neuritis and neuralgia;
• acute and chronic myositis;
• myalgia and joint pain of unspecified etiology;
• bruises, sprains, dislocations, ruptures of tendons and ligaments;
• recovery period after severe limb injuries;
• postoperative period during intervention on the abdominal organs or extremities;
• bursitis without suppuration in the joint capsule;
• Tenosynovitis, synovitis.

Side effects

During the period of use of the described pharmacological drug, the following body disorders may develop:

1. Peripheral and central nervous system: drowsiness, cephalgia, dizziness; aseptic meningitis (including fever, convulsions, migraines, stiff neck), excessive activity (including severe anxiety, mood swings), depressive disorders, hallucinations, psychosis.
2. Respiratory system: dyspnea, pulmonary edema, bronchospasm, rhinitis, swelling of the laryngeal tissue (including difficulty breathing, shortness of breath).
3. Heart and blood vessels: increased pressure, fainting.
4. Digestive system: gastralgia, diarrhea, flatulence, vomiting, stomatitis, constipation, feeling of excessive stomach fullness, nausea, loss of appetite, erosive and ulcerative lesions of the structures of the digestive tract (including those accompanied by bleeding or perforation - abdominal pain, melena, spasm in the epigastric zone , nausea, vomiting with blood, heartburn), cholestatic jaundice, liver inflammation, acute pancreatitis, hepatomegaly.
5. Coagulation system: nasal or rectal bleeding, bleeding from postoperative wounds.
6. Hematopoietic system: eosinophilia, leukopenia, anemia.
7. Urinary system: lower back pain, acute renal failure, hematuria, azotemia, hemolytic-uremic syndrome (hemolytic anemia, thrombocytopenia, purpura), decreased or increased urine volume, edema of renal origin, frequent urination, nephritis.
8. Skin: purpura, rashes (including maculopapular), exfoliative dermatitis (including fever, peeling, redness or thickening of the skin, swelling or tenderness of the tonsils), Stevens-Johnson syndrome, Lyell's syndrome.
9. Sense organs: ringing in the ears, changes in visual functions (blurred vision), hearing loss.
10. Local reactions: burning or pain at the injection site.
11. Allergic phenomena - anaphylactoid reactions (including changes in facial skin tone, urticaria, skin rash, dyspnea or tachypnea, periorbital edema, swelling of the eyelids, shortness of breath, difficulty or wheezing).
12. Other adverse reactions: weight gain, swelling (including of the face, ankles, legs, fingers, feet), increased sweating, swelling of the tongue, fever.

Which is better Ketonal or Ketorol

When choosing which drug to prescribe, the doctor studies its characteristics: indications, contraindications, development of adverse reactions. In some cases, Ketonal will cope well, in others - Ketorol.

For osteochondrosis

Only a doctor should determine which drug is best to use for osteochondrosis. It all depends on at what stage of the disease they are used. Ketonal is used for the inflammatory process that accompanies cervical chondrosis, and Ketorol effectively eliminates pain.

For pain

When pain occurs, including headaches and dental pain, Ketorol, which is a powerful analgesic, provides better pain relief. Ketonal does not have such an effect.

Indications and contraindications for use

The main indication for the use of the drug is its one-time use to relieve severe pain:

• after the operation;
• for damage and injury.

In addition, Ketanov is actively used for pain relief for:

• toothaches;
• renal or hepatic colic;
• otitis;
• sciatica;
• diseases of the musculoskeletal system (sciatica, arthritis, osteochondrosis);
• oncology.

Ketanov, like any other drug, cannot be used in all cases. There are a number of restrictions, which include the following conditions:

• high sensitivity to the components of the product;
• a history of peptic ulcers, gastrointestinal bleeding, stomach ulcers;
• bronchial asthma, runny nose, angioedema, urticaria, provoked by taking aspirin or non-steroidal anti-inflammatory drugs;
• history of bronchial asthma;
• nasal polyps, bronchospasm, Quincke's edema;
• before or during surgery (lasting without pain relief);
• after surgery with a high probability of potential or incomplete stopping of bleeding;
• taking anticoagulants, including heparin;
• cerebrovascular bleeding (suspected or diagnosed);
• problems with blood clotting;
• hypovolemia, dehydration;
• severe heart failure;
• hemorrhagic stroke;
• pregnancy, pain during labor and childbirth;
• lactation period;
• age under 16 years.

When do doctors prescribe this medication?

Today, many experts recommend that patients take Ketorolac tablets. What does this drug help with? As already mentioned, this remedy has a powerful analgesic effect. It is recommended to be used for temporary relief of pain of various origins, including headaches and toothaches, discomfort during menstruation, etc.

What about Ketorolac injection solution? The injections are intended to relieve severe pain, and in most cases they are prescribed to patients in the postoperative period. It is immediately worth noting that, despite the quick and powerful effect, the drug is prohibited from being administered before surgery. It is also not used in obstetric practice. The fact is that the medicine affects blood clotting - there is a high probability of bleeding.

You also need to understand that the drug can only relieve pain, but it does not eliminate the causes of its occurrence.

Composition and release form

This medication is available in the following forms:

• Solutions for intramuscular and intravenous use: transparent liquid, yellowish in color, 1 ml in ampoules, 10 or 5 ampoules in trays, 2 or 1 tray in cardboard packaging; 2 ml in dark glass ampoules, 10 pieces in a cardboard box.
• Ketorolac solution for intramuscular use: transparent, light yellow, 1 ml in glass ampoules, 5 ampoules in pallets, 2 or 1 pallet in a cardboard box, or 10 or 5 ampoules in a cardboard box; 2 ml in dark glass ampoules, 10 pieces in a cardboard pack.

1 ml of medicinal solution for intramuscular and intravenous use contains:

• active ingredient: ketorolac trometamol (ketorolac tromethamine);
• additional components with auxiliary functions: disodium edetate (disodium salt 2-aqueous ethylenediamine-N,N,N',N'-tetraacetic acid), sodium chloride, injection water.

1 ml of solution for intramuscular use contains:

• active element: ketorolac trometamol;
• excipients: edetate disodium dihydrate (Trilon B), ethanol (ethyl alcohol converted to anhydrous), sodium chloride, propylene glycol, sodium hydroxide.

Pharmacokinetics of the drug

The active component of the pharmacological agent is quickly absorbed in the organs of the digestive system, namely in the small intestine. When taking tablets, its maximum concentration in the blood is observed after 40-50 minutes. It is noted that taking the medicine with food almost doubles the time of absorption and onset of the therapeutic effect.

The bioavailability of the drug is almost 99%, which explains its effectiveness. When using an injection solution, the absorption period is slightly shortened and the result is observed earlier. The active substance accumulates in small quantities in tissues, blood and synovial fluid.

When using the external form, the drug is also quickly absorbed, concentrated in the blood in small quantities, and quickly eliminated. Metabolism of the active component occurs in the liver, where it breaks down into inactive metabolic products.

The elimination period takes no more than 6 hours in the absence of pathologies of internal organs. The main amount of metabolites is excreted in the urine and a small proportion in the feces. If the functioning of the kidneys is impaired, the time it takes for the body to free itself from waste products increases by several hours.

Overdose and side effects

In rare cases, an overdose occurs when taking Ketorol. If this happens, the patient feels:

• increased pain;
• nausea;
• vomiting;
• pain in the kidney area (their functions are impaired)
• Metabolic acidosis may develop.

In these cases, you should immediately stop using the drug, even in minimal quantities. Treatment is symptomatic therapy prescribed by a doctor.

If the drug is not ingested through injection into the muscle, it is necessary to immediately induce vomiting. An overdose of an injection solution is possible at different concentrations due to the individual characteristics of the human body.

Sometimes the body may experience negative reactions to the use of the drug. Ketorol is no exception; side effects manifest themselves in the form of:

Regardless of the cause of the pain, in many cases the first line of treatment is. Today, medications in this group are presented in a wide range, and when choosing the most optimal option, the intensity of the pain syndrome, the presence of concomitant diseases and some other factors are taken into account. Let's consider in what cases the use of one of these drugs, Ketorol, in the form of injections is recommended.

Composition and properties of the drug Ketorol for injections

Ketorol for injections is available in ampoules containing 1 ml of solution. The active ingredient of the drug is ketorolac. Excipients of the solution:

• sodium chloride;
• ethanol;
• water;
• sodium hydroxide, etc.

The drug has the following effect:

• weak antipyretic;
• anti-inflammatory;
• pronounced analgesic.

The onset of the analgesic effect is observed already half an hour after the administration of Ketorol in injection form. The maximum effect is observed after 1-2 hours, and the duration of the therapeutic effect is about 5 hours.

Indications for the use of Ketorol injections

The injection form of the drug Ketorol is recommended for use in case of moderate and severe pain syndrome of any localization to obtain a quick analgesic effect. This form of the drug is prescribed in cases where taking Ketorol in tablets is impossible. It is advisable to use Ketorol injections in the treatment of acute conditions, and not for the treatment of chronic pain syndromes.

So, Ketorol injections can be used for:

• postoperative pain;
• post-traumatic pain;
• pain associated with tumor diseases;
• muscle and joint pain;
• rheumatic diseases;
• migraines;
• renal and hepatic colic;
• etc.

Dosage of Ketorol injections

Ketorol painkilling injections are performed intramuscularly, less often intravenously. As a rule, the solution is injected into the outer upper third of the thigh, shoulder, and buttock. It is necessary to inject deeply into the muscle, slowly.

The dosage of the drug is selected individually by the attending physician, but therapy should always begin with the minimum dose, and then be guided depending on the patient’s response and the achieved effect. For patients under 65 years of age, a single dose of Ketorol can range from 10 to 30 mg. Injections can be repeated every 4 to 6 hours, and the maximum daily dose should not exceed 30 ml.

Side effects of Ketorol injections

When treated with Ketorol in the form of injections, side effects may occur from various organs and systems, namely:

• stool disorders;
• nausea;
• abdominal pain;
• headache;
• bleeding;
• difficulty breathing;
• swelling;
• skin rash;
• increased blood pressure;
• sweating;
• insomnia;
• urinary retention, etc.

Ketorol injections and alcohol

Injections of this drug are not compatible with drinking alcoholic beverages. Drinking alcohol during treatment with Ketorol not only reduces the effectiveness of the drug (the duration of action decreases), but also increases the risk of developing side effects. Therefore, during the treatment period you should refrain from drinking alcohol.

Contraindications to Ketorol injections

Description of the drug

Ketorol is a transparent gel without foreign particles with a yellowish tint and a pleasant odor. It contains no fatty ingredients, so it is quickly absorbed by the skin. The therapeutic effect of Ketorol manifests itself immediately after the penetration of ketorolac into pathological foci. The anti-inflammatory drug is characterized by high bioavailability and a long-lasting analgesic effect. What does Ketorol ointment help with:

• persistent pain accompanying degenerative-dystrophic pathologies of the joints;
• inflammatory edema, which always forms when connective tissue structures are injured;
• severe pain, increased local temperature, limitation of movements that occur with systemic inflammatory pathologies.

The gel is usually used to eliminate pain that appears during remission or at the final stage of treatment. But in some cases, orthopedists prescribe Ketorol for acute attacks of lumbago or lumbar sciatica. This allows you to reduce the pharmacological load on the body by reducing the doses of tablets and injections.

Clinical and pharmacological group

Ketorol is a representative of the clinical and pharmacological group of non-steroidal anti-inflammatory drugs. It refers to drugs intended for local treatment of pathologies of the musculoskeletal system.

pharmachologic effect

The therapeutic effect and range of application of Ketorol ointment is due to the pharmacological properties of Ketorolac. This acetic acid derivative inhibits the activity of cyclooxygenases type 1 and 2. Inhibition of the enzyme leads to blocking the biosynthesis of mediators of pain, inflammation and fever.

Improvement in human well-being occurs as a result of a decrease in the concentration of prostaglandins, bradykinins and leukotrienes. The penetration of macrophages into pathological foci is also limited. Even a single application of the gel has a multifaceted positive effect on the joints and spine:

• inflammatory processes occurring in the ligamentous-tendon apparatus, bone, and cartilaginous tissues are stopped;
• inflammatory swelling that compresses soft tissues, blood vessels, and sensitive nerve endings is eliminated;
• the severity of pain, burning, and “aches” in the joints decreases.

Due to a combination of therapeutic effects, ketorolac stimulates the improvement of blood supply to tissues with nutrients. The result is an acceleration of metabolism and restoration of damaged joint and vertebral structures.

Release form and composition

An Indian manufacturer produces 2% gel in 20 g packaging. It is placed in laminated aluminum tubes with a screw-on polyethylene cap. The secondary packaging for the medicine is a cardboard box with instructions for use. The active substance of Ketorol is ketorolac. The auxiliary composition of the gel is represented by the following ingredients:

• dimethyl sulfoxide;
• propylene glycol;
• carbomer;
• propyl parahydroxybenzoate;
• methyl parahydroxybenzoate;
• tromethamine;
• ethyl alcohol;
• glycerol;
• purified water;
• flavoring.

Dimethyl sulfoxide exhibits anti-inflammatory, decongestant, and analgesic activity. It significantly enhances and prolongs the therapeutic effect of ketorolac. The remaining additional ingredients ensure rapid penetration of the active component through the skin into damaged tissues.

All dosage forms from the Ketorol therapeutic line have a pronounced anti-inflammatory effect. These are biconvex tablets and solution for parenteral administration.

Contraindications

The manufacturer identifies risk groups for whom it is not recommended to take Ketorol. This includes people with complex pathologies or changes in the body; they are recommended to look for other painkillers, after consulting with a specialist.

• in case of pregnancy and lactation (during breastfeeding);
• persons under 16 years of age;
• for systemic diseases of the gastrointestinal tract (stomach and duodenal ulcers);
• in cases of kidney, heart or liver failure;
• with reduced blood clotting (hemophilia);
• in case of allergy to the active substance ketorol - ketorolac;
• if you have problems with the respiratory system (asthma, nasal polyposis).

Ketorol should be taken with other medications very carefully and only after consulting a doctor. It is not recommended to use two products with a strong analgesic anti-inflammatory effect together at once.

If you took the drug immediately before visiting the dentist, you should tell him about it, otherwise the diagnosis of your problem may be ineffective.

Video: description of Ketorol

Analogs of Ketorol tablets

Knowing everything about Ketorol (tablets), it’s also easy to find an analogue. These are "Aertal" tablets - 300 rubles, "Naklofen Duo" capsules - 113 rubles, "Indomethacin" tablets - 30-45 rubles, as well as cheap synonyms - "Ketanov" tablets - 60 rubles and "Ketokam" - 40-60 rubles .

Let's take a closer look at the Ketorol analogue in tablets - the drug Indomethacin. This is a substitute containing not ketorolac, but the active substance indomethacin, which is similar in action to it.

Tablets are prescribed for headaches, toothaches, arthritis of varying complexity, and soft tissue damage.

Indomethacin also has antipyretic, anti-inflammatory and analgesic properties. Complete relief of pain occurs two hours after taking the tablet.

It is not recommended to take this drug for people with high blood pressure, patients with stomach ulcers, those with vision problems, pregnant women, nursing mothers, and children under 18 years of age.

The drug "Indomethacin" can cause insomnia, dizziness, itching, increased blood pressure, bronchospasm, tinnitus, changes in taste perception, and increased sweating.

Ketorolac's analogs

The drug helps with headaches, after surgery, with inflammatory diseases of the musculoskeletal system, and is used in dentistry. Due to its low cost, the medicine is not always available in pharmacies. Due to side effects, a large list of contraindications, and defects, the issue of selecting analogues of the drug Ketorolac is relevant.

One group of substitutes are synonyms or preparations in ampoules and tablets with the same active substance. These include Ketorol, Ketanov, Ketofril, Dolak. Analogs differ in bioavailability, frequency of side effects, manufacturer, and price.

Another large group of Ketorolac substitutes are drugs that have analgesic and anti-inflammatory effects and have the same indications. Analogs differ in active ingredient, price, contraindications, manufacturer, and effectiveness.

Analogues of the drug Ketorolac with approximate prices and country of origin

Ketoprofen

Manufacturer: Vertex and Ozone, Biocom, Borisov plant, Synthesis and Grotex, Organics, Russia or Belarus
Release form: gel, tablets, injections

Active ingredient: ketoprofen

Synonyms: Artrosilene, Artrum, Bystrumcaps, Bystrumgel, Fastum gel, Ketonal, OKI, Flamax, Flexen, Febrofid, etc.

An analogue of Ketorolac in injections and tablets, the domestic drug Ketoprofen is available with a doctor’s prescription. It has a pronounced analgesic and anti-inflammatory effect, mainly prescribed for inflammatory and degenerative diseases of the joints and spine. For complex treatment, it is used topically in gel form.

According to studies, when using Ketoprofen, the risk of side effects from the gastrointestinal tract (abdominal pain, ulcerations and erosions) is up to 2 times lower compared to Ketorolac. However, its analgesic activity is much less pronounced.

Ketanov

Manufacturer: S.K. Therapy, Romania
Release form: tablets, ampoules

Active ingredient: ketorolac

An analogue of Ketorolac tablets is the imported drug Ketanov with the same active ingredient. It is also produced in the form of ampoules and is sold strictly as directed and with a doctor’s prescription. Indications for use and contraindications for the analogue are the same as for Ketorolac.

Meloxicam

Manufacturer: Akrikhin, Teva, Ozone, Vertex, Canonpharma, Stada, Russia or Hungary, DS, China
Release form: tablets, ampoules, suppositories

Active ingredient: meloxicam

Synonyms: Movalis, Mesipol, Movasin, Artrosan, Amelotex, Meloflex, Genitron, etc.

Meloxicam is mainly a domestic or Chinese analogue in ampoules and tablets. Distinctive features of the medicine:

• pronounced anti-inflammatory effect;
• in the form of ampoules, used once a day for 5 days for pain relief and relief of inflammation;
• the tablet form is prescribed independently or after a course of injections to prolong the therapeutic effect 1–2 times a day, depending on the dosage;
• It is well tolerated, but if dosages are not observed, like Ketorolac, the analogue accumulates in the body and leads to side effects.

Meloxicam is dispensed as prescribed by a doctor.

Dexalgin

Manufacturer: A. Menarini, Italy
Release form: tablets, granules, ampoules

Active ingredient: dexketoprofen

Synonyms: Flamadex, Ketodexal, Dexonal

Dexalgin ampoules are sold by prescription and are prescribed once a day to relieve acute pain. Tablets and granules are over-the-counter forms and are used every 6-8 hours.

The analog has a pronounced antipyretic and analgesic effect, the anti-inflammatory effect is weakly expressed.

special instructions

Ketorol has two dosage forms (film-coated tablets and solution for intravenous and intramuscular administration). The choice of method of drug administration depends on the severity of the pain syndrome and the patient’s condition.

Before prescribing the drug, it is necessary to clarify the issue of a previous allergic reaction to the drug or NSAID. Due to the risk of allergic reactions, the first dose is administered under close medical supervision.

Hypovolemia increases the risk of nephrotoxic adverse reactions.

It is not recommended for use as a drug for prophylactic pain relief, before and during major surgical interventions due to the high risk of bleeding.

The drug should not be used together with NSAIDs (including COX-2 inhibitors), because when taken together with other NSAIDs, fluid retention, cardiac decompensation, and increased blood pressure may occur. The effect on platelet aggregation ceases after 24–48 hours.

The drug may change the properties of platelets.

The risk of developing drug complications increases with lengthening of treatment (patients with chronic pain) and increasing the dose of the drug to more than 90 mg/day.

To reduce the risk of adverse events, the minimum effective dose should be used for the shortest possible short course.

To reduce the risk of developing NSAID gastropathy, misoprostol and omeprazole are prescribed.

Ketarolac price, where to buy

In Russia, the price of Ketorolac No. 10 ampoules is 99-101 rubles, the price of Ketorolac No. 20 tablets is approximately 18 rubles. In Ukraine, ampoules of drug No. 10 cost 54-75 hryvnia, tablets No. 10 cost 9-25 hryvnia.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Ketorolac solution for intravenous and intramuscular injection.
  30mg/ml amp. 1ml No. 10Ozon LLC 86 rub. order
• Ketorolac tab. p.p.o. 10 mg n20AO Tatkhimfarmpreparaty

  21 rub. order

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PaniPharmacy

• KETOROLAC ampoule Ketorolac r/r d/in.
  3% 1ml. No. 10 Ukraine, Health LLC 99 UAH. order
• KETOROLAC tablets Ketorolac tablets. 10mg No. 10 Ukraine, Health LLC

  18 UAH order

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Compatibility with drugs

According to the instructions for use, Ketorol and paracetamol tablets can be used in combination for no more than two days.

It is recommended to avoid combination with other non-hormonal anti-inflammatory medications, as well as Pentoxifylline and Probenecid. When combined with drugs containing methotrexate, Ketorol can cause an increased toxic effect on the circulatory system and kidneys. Combination with paracetamol increases the negative effect on the renal system.

Ketorolac and methotrexate in combination are used only at a minimum dosage of the latter. The patient will have to regularly donate blood to monitor the concentration of this substance in the plasma component. The clearance of methotrexate may be reduced by ketorolac. A similar effect is observed when combining the described medication and lithium.

As the instructions for use point out, “Ketorol” (and tablets, injections that have a negative effect on blood clotting) can together cause bleeding. This forces us to extremely carefully combine injections and drugs containing:

• cefoperazone;
• cefotetan;
• heparin;
• warfarin;
• pentoxifylline.

Similar restrictions are imposed on the combination of ketorolac and antiplatelet agents and thrombolytics.

"Ketorol" allows you to reduce the amount of narcotic painkillers. When combined with diuretics and blood pressure lowering agents, it is taken into account that the effectiveness of these drugs is reduced because the production of prostaglandins by the kidneys is inhibited.

You can use Ketorol in the form of injections and antacids - these substances do not correct absorption rates.

When using hypoglycemic drugs in tablet form, Ketorol insulin increases their activity.

Pregnancy and lactation

and period

. Pregnant women should choose other approved pain medications, such as ibuprofen,

Ketorol gel can be used with caution during the first and second trimesters of pregnancy, that is, up to the 27th week of gestation inclusive. Caution lies in careful prevention of possible accidental ingestion of the drug, for example, licking off the gel remaining on the lips after they were rubbed with hands that were not washed after applying the product, etc.

In the third trimester of pregnancy, that is, from the 28th week until delivery, Ketorol gel cannot be used, as this may cause post-term pregnancy or complications of labor.

Before taking any medicine, consult your doctor or pharmacist.

If you become pregnant during treatment, see your doctor as soon as possible.

Do not take ketoprofen during the last trimester of pregnancy as non-steroidal anti-inflammatory drugs can cause serious problems in the fetus or complications during childbirth.

Do not take ketoprofen if you are breastfeeding.

Analogs

Level 4 ATC code matches:
Voltaren

Rapten

Zerodol

Dickloberl Retard

Dikloberl N 75

Dicloberl

Ketanov

Dolak

Panoxen

Naklofen Duo

Olfen-100

Olfen-75

Neurodiclovit

Nizilat

Fanigan

Aertal

Methindol

Ortofen

Ketarolac analogues: Ketanov, Ketorol, Ketonort, Ketorolac-Credofarm and others.

Compound

Composition of tablets: ketorolac (10 mg/tablet), MCC, lactose, corn starch, colloidal silicon dioxide, Mg stearate, Na carboxymethyl starch (type A).

The film shell contains: hypromellose, propylene glycol (additive E1520), titanium dioxide; dyes brilliant blue (22%) and quinoline yellow (78%) - olive green.

Composition of the solution: ketorolac (30 mg per milliliter), octoxynol, EDTA, Na chloride, ethanol, propylene glycol (additive E1520), Na hydroxide, water for injection.

Gel composition: ketorolac (20 mg per gram of gel), propylene glycol (additive E1520), dimethyl sulfoxide, carbomer 974P, Na methyl and propyl parahydroxybenzoate, tromethamine (trometamol), Drimon Inde flavoring, ethanol, glycerol, purified water.

Interaction with other drugs

Do not forget about the compatibility of the active substance with other medications, namely:

1. Simultaneous use with Paracetamol increases the negative effect of Ketorolac;
2. Combined use with narcotic analgesics leads to increased analgesia. Therefore, the amount of the drug taken is reduced;
3. The simultaneous use of several NSAIDs contributes to irritation of the gastric mucosa and bleeding;
4. This drug reduces the effect of diuretics;
5. Myelotoxic drugs increase the harmful effects of the described medication.

Precautionary measures

Negative effects from taking medication can often be avoided if certain safety precautions are followed during treatment.

Drug interactions

If the patient is already taking Methotrexate or Paracetamol, injections with Ketorol should not last more than two days. Otherwise, the liver is affected. Simultaneous use of drugs is possible only with a minimum dosage of Methotrexate. However, its level in the blood must be constantly checked and regulated.

Combined treatment with other NSAIDs is contraindicated. Otherwise, problems with the gastrointestinal tract arise. The result of these processes can be ulcers, erosion and bleeding in the intestines. A similar effect is created by the combination of Ketorol with Acetylsalicylic acid.

NSAIDs, antibiotics, and immunosuppressants together with Ketorol can cause the development of nephrotoxicity.

Medicines that regulate blood pressure and diuretics lose their effectiveness when taken simultaneously with Ketorol.

Combined use with Valproic acid increases the risk of blood clots.

Warfarin, Cefotetan and other drugs related to indirect anticoagulants, when interacting with ketorolac, provoke bleeding.

A tennis ball will relieve back pain in 6 minutes

There is an opinion that only expensive massage courses help relieve tension and pain in the interscapular area. In fact, you can cope with such symptoms on your own and completely free of charge. All you need for this is a regular tennis ball.

The massage algorithm is simple:

• press the ball with your back against the wall so that it does not slip down and fall to the floor;
• roll the ball with your back along the surface of the wall, thus massaging the affected areas;
• perform some simple exercises for your back.

The described set of exercises should be repeated regularly. Contraindications to its implementation can only be febrile conditions and pathologies, in which stress on the body is excluded.

Reviews

Svetlana, Volgodonsk
Previously, I used cheaper analogues of Ketorol ointment for exacerbations of osteochondrosis. The substitutes helped, but for a very short time. And Ketorol coped with pain and stiffness of movement for several hours. The drug also helps with sprains and severe bruises.

Elena, Volgograd

I always use Ketorol for grade 1 coxarthrosis. It relieves well the nagging, aching pain that occurs during a sudden change in weather. The packaging is relatively small, but it lasts a long time because you don’t need to apply a lot of ointment.

How to use

The manufacturer points out: Ketorol must be used in the minimum dosage that shows effectiveness. The dose is selected by the doctor, assessing the intensity of the pain syndrome.

If the need arises, you can combine the described drug and narcotic painkillers, using the second group in minimal quantities.

For a group of patients aged 16-64 years weighing 50 kg or more, injectable Ketorol is indicated in an amount of up to 60 mg per procedure

As the instructions for use note, Ketorol tablets and injections can be used simultaneously, in which case a single dose takes into account all forms of use. Classic course format – 30 mg with six-hour breaks between procedures

The substance can be injected into a vein at a dose of 30 mg, in two days - no more than six procedures.

For adult patients weighing less than 50 kg, Ketorol is injected into the muscle tissue, taking into account that a single dose should be within 30 mg (tablets are taken into account if the patient takes them). More often, the drug is used in doses of 15 mg, administering the drug no more than eight times over two days. It is recommended to maintain six-hour intervals between procedures.

The maximum amount of ketorolac per day for a patient whose weight is more than 50 kg and whose age is between 16-64 years is 90 mg for 24 hours. With lower body weight, in old age, with insufficient kidney function, 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. The drug must be injected deeply and slowly into the muscle. The primary effect is observed half an hour after the injection, the maximum effect is observed after an hour or two. The duration of pain relief is up to six hours (sometimes four or a little more).

Chondroprotectors

If it is necessary to eliminate back pain caused by spinal diseases accompanied by degenerative disorders, chondroprotectors are prescribed. The main indications for the use of chondroprotectors: polyosteoarthrosis and osteochondrosis.

Injection solutions are administered intra-articularly or deep intramuscularly. Typically, the course of treatment is quite long and may include several periods of injections and breaks. Chondroprotectors, as a rule, do not provide a quick effect, but with proper and sufficiently long-term treatment they can avoid relapses of back pain if the patient has certain spinal diseases.

If your back hurts, you need to see a doctor for a diagnosis. Only based on its results can injections against pain be prescribed.

Additional Information

The instructions recommend storing Ketorol in a dark place where the air temperature does not rise above 25 0 C. The shelf life of Ketorol tablets and solution for injection is 3 years.

Ketorol: prices in online pharmacies

Oleg / September 28, 2019, 01:03

Severe toothache forced me to buy ketarol tablets. I immediately took one tablet at the pharmacy. The pain subsided a little, but did not disappear. And now about the sad thing. Half an hour later: my head started to feel dizzy after just one pill. It became difficult to remember basic words and concentrate. The ears (inside) began to itch very much. My tongue went numb. An hour later: My whole head itched and hurt, my ears were blocked, I started feeling nauseous. My eyes hurt. It became hot and cold. The pain in the tooth has intensified (but is still tolerable). By the way, 90 minutes have passed since taking it. The tooth hurt again, but the side effects are subsiding.

I do not recommend these pills!

Nadezhda doctor / September 28, 2019, 11:15 pm

Severe toothache forced me to buy ketarol tablets. I immediately took one tablet at the pharmacy. The pain subsided a little, but did not disappear. And now about the sad thing. Half an hour later: my head started to feel dizzy after just one pill. It became difficult to remember basic words and concentrate. The ears (inside) began to itch very much. My tongue went numb. An hour later: My whole head itched and hurt, my ears were blocked, I started feeling nauseous. My eyes hurt. It became hot and cold. The pain in the tooth has intensified (but is still tolerable). By the way, 90 minutes have passed since taking it. The tooth hurt again, but the side effects are subsiding.

I do not recommend these pills!

Oleg, what you described is an allergic reaction. This is a manifestation of individual hypersensitivity; such a reaction does not mean that the drug is bad, it means that it is contraindicated for you.

Do you know that:

According to statistics, on Mondays the risk of back injuries increases by 25%, and the risk of a heart attack by 33%. Be careful.

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Millions of bacteria are born, live and die in our intestines. They can only be seen under high magnification, but if they were put together, they would fit in a regular coffee cup.

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Scientists from Oxford University conducted a series of studies in which they came to the conclusion that vegetarianism can be harmful to the human brain, as it leads to a decrease in its mass. Therefore, scientists recommend not completely excluding fish and meat from your diet.

A person taking antidepressants will, in most cases, become depressed again. If a person has coped with depression on his own, he has every chance to forget about this condition forever.

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Pharmacokinetics

The pharmacokinetics of ketorolac after single and repeated intravenous and intramuscular administration is linear.

With intramuscular administration, absorption is complete and rapid. Cmax after intramuscular administration of 30 mg is 1.74–3.1 μg/ml, 60 mg is 3.23–5.77 μg/ml, Tmax is 15–73 and 30–60 minutes, respectively. Cmax after intravenous administration of 15 mg - 1.96-2.98 mcg/ml, 30 mg - 3.69-5.61 mcg/ml, Tmax - 0.4-1.8 and 1.1-4, 7 min respectively. Communication with plasma proteins - 99%.

Vd with intramuscular administration is 0.136–0.214 l/kg, with intravenous administration—0.166–0.254 l/kg. In patients with renal failure, the Vd of the drug may increase by 2 times, and the Vd of its R-enantiomer by 20%.

More than 50% of the administered dose is metabolized in the liver with the formation of pharmacologically inactive metabolites. The main metabolites are glucuronides, which are excreted by the kidneys, and the pharmacologically inactive p-hydroxyketorolac. Excreted by the kidneys (91%) and through the intestines (6%).

T1/2 in patients with normal renal function is 3.5–9.2 hours after parenteral administration of 30 mg. T1/2 increases in elderly patients and shortens in young ones. Changes in liver function do not affect T1/2. In patients with impaired renal function with a plasma creatinine concentration of 19-50 mg/l (168-442 µmol/l), T1/2 is 10.3-10.8 hours, with more severe renal failure - more than 13.6 hours.

When 30 mg of ketorolac is administered intramuscularly, the total clearance is 0.023 l/kg/h (0.019 l/kg/h in elderly patients); in patients with renal failure (with a plasma creatinine concentration of 19–50 mg/l) - 0.015 l/kg/h. When 30 mg of ketorolac is administered intravenously, the total clearance is 0.03 l/kg/h.

Not excreted by hemodialysis.

Composition of dosage forms

The active component of any type of drug is the substance ketorolac. The instructions for use indicate that ketorolac is present in varying degrees of concentration in each form of the drug:

• gram of gel contains 20 mg of active substance dissolved in a mixture of purified water, ethyl alcohol and glycerol with the addition of flavor and auxiliary substances;
• the tablet contains 10 mg of ketorolac with the addition of corn starch, cellulose, lactose and other components;
• The attached instructions indicate that the injection solution contains 30 mg of ketorolac, prepared on the basis of deionized water, ethyl alcohol, sodium chloride, and other additional substances.

Clarification: Ketorol injectable form is preferable to prescribe for quick relief of pain, as well as when it is impossible to take pills due to stomach diseases (ulcers, gastritis, gag reflex, etc.). The instructions indicate that Ketorol (ampoules and tablets) is available with a prescription.

Basic information about the medication

Ketorol belongs to the group of drugs NSAIDs (non-steroidal anti-inflammatory drugs), a class of derivatives of pyrrolysine-carboxylic acid. Any form of the drug has an analgesic and anti-inflammatory effect with signs of a moderate antipyretic effect. However, after using Ketorol injections, the analgesic effect is much stronger and occurs faster, unlike other types of medication.

1. Gel. A homogeneous transparent substance, used externally, has a characteristic odor, packaged in tubes of 30 g.
2. The tablets are greenish in color, biconvex in shape, packaged in packs of 20 pieces. A distinctive feature of Ketorol tablets is the presence of the letter “S” on one side.
3. Ampoules (glass) of 1 ml with a solution for intramuscular and intravenous administration are equipped with a recess for breaking and a ring. The package contains 10 ampoules.

Reference: Ketorol in tablet and injection form is used to relieve pain not only of moderate intensity, but also to relieve severe pain of various natures. The gel is prescribed to reduce pain and inflammation at the sites of application.

Injection form of the drug

The drug Ketorol is a version of the drug with ketorolac, produced by the Indian pharmaceutical company Dr. Reddy's Laboratories. Ketorol is sold in various dosage forms. One of the most common is an injection solution. One milliliter of solution (the contents of one ampoule) contains 30 mg of ketorolac.

The solution also contains, in addition to water:

• disodium edetate,
• octoxynol,
• sodium chloride,
• propylene glycol,
• ethanol,
• sodium hydroxide.

Externally, the solution looks like a transparent liquid without color or having a slightly yellowish tint. A solution suitable for use should not have any inclusions.

The solution contained in the ampoules is a completely ready-to-use form of the drug, and therefore in most cases there is no need to dilute it with other substances. Although, if necessary, you can add the contents of the ampoule to a dropper and introduce it into the body by infusion. The method of administration in this case is determined by the attending physician.

The solution is preferable to use in cases where the patient cannot swallow tablets (for example, with a gag reflex), or when the fastest onset of analgesic effect is required. After all, the drug in the form of a solution shows its effect much earlier than the drug in the form of tablets. Although the overall bioavailability in these two cases is approximately the same. In addition, parenteral administration eliminates some negative reactions associated with the gastrointestinal tract, such as nausea, diarrhea, and abdominal pain. The solution can be administered either intravenously or intramuscularly.

Ampoules with solution must be stored at a temperature not exceeding +25 °C. The solution must not be frozen.

The drug in ampoules can be purchased at the pharmacy only if the doctor writes a prescription for Ketorol.

In the absence of the drug Ketorol, you can find its analogues, which also contain ketorolac, for example, solution for injection Ketanov. You can also find a solution called Ketorolac in pharmacies.

pharmachologic effect

Tablets and solution: analgesic, anti-inflammatory, antipyretic.

Gel: analgesic, local anti-inflammatory.

Analgesic, anti-inflammatory, antipyretic, antiplatelet. Solution for intravenous and intramuscular administration, Ketorolac tablets are classified as NSAIDs, have a pronounced analgesic effect, and also have anti-inflammatory and moderate antipyretic effects. The mechanism of action is associated with non-selective inhibition of the activity of COX-1 and COX-2, which catalyzes the formation of PGs from arachidonic acid, which play an important role in the pathogenesis of pain, inflammation and fever.

Ketorolac is a racemic mixture of S(−)- and R( )-enantiomers, and the analgesic effect is due to the S(−)-form. The analgesic effect is comparable to morphine and significantly superior to other NSAIDs. The onset of the analgesic effect of ketorolac in the form of a solution for intravenous and intramuscular administration is noted after 0.5 hours, the maximum effect is achieved after 1–2 hours and lasts about 4–6 hours.

After oral administration in the form of tablets, the onset of analgesic effect is noted after 1 hour, the maximum effect is achieved after 2–3 hours. Eye drops After local ophthalmic use, ketorolac reduces the PG content in the aqueous humor. When used systemically, ketorolac does not cause pupil constriction.

According to the results of clinical studies, ketorolac does not have a significant effect on IOP. Gel for external use When applied topically, it causes a weakening or disappearance of pain at the site of application of the gel, incl. pain in the joints at rest and during movement, reduces morning stiffness and swelling of the joints. Helps increase range of motion.

Mode of application

To relieve pain, they are used 2 times a day - in the morning and before bed.

Before using suppositories, the patient should have a bowel movement and shower. If bowel movements are difficult, it is recommended to take a mild laxative or give an enema. It is more convenient to insert the candle while lying on your side with your knees bent. The procedure can also be performed while kneeling or squatting.

The suppository is carefully pushed into the anus using the index finger to a depth of 5 cm. After inserting the suppository, the patient is advised to lie down for a while so that the melted suppository does not leak out. To prevent possible minor leakage of the product, you can use a sanitary pad.

Storage conditions must be observed; candles must be stored out of the reach of children at a temperature no higher than 25˚C and no more than 5 years. It is more convenient to keep the package in the refrigerator.

Ketonal suppositories are an effective drug that has a quick effect. But you cannot increase the course of prescribed treatment on your own. This can lead to the development of ulcers in the rectum. Treatment should only take place under the supervision of a doctor and strictly according to his recommendations.

Always use Ketonal suppositories exactly as prescribed by your doctor. If you are unsure about anything, consult your doctor or pharmacist.

Undesirable effects can be minimized by using the lowest dose for the minimum amount of time required for treatment.

Do not change the dose or stop treatment without first consulting your doctor.

Unwrap and moisten the suppository with water, then gently push it into the anus (rectum). Empty your bowels if necessary before administering the suppository.

Empty your bowels if necessary before administering the suppository.

Extend your legs and remain in this position for several minutes to allow the suppository to melt and the medicine to be absorbed. Wash your hands after the procedure.

- one Ketonal capsule (50 mg) in the morning and lunch and one suppository (100 mg) in the evening or

- one tablet of Ketonal forte (100 mg) in the morning and one suppository (100 mg) in the evening. Ketonal capsules or forte tablets are taken orally and should be taken during or after meals with at least 100 ml of water or milk.

The duration of treatment will be determined by the attending physician.

Elderly patients: Elderly patients usually have a reduced dose.

Children: Dosage for children under 18 years of age has not been established.

If you feel that the effect of the medicine is too strong or too weak, tell your doctor or pharmacist.

For questions regarding the use of the drug, contact your doctor or pharmacist.

A solution of the drug Ketorol is used in minimally effective doses, selected according to the intensity of pain. If necessary, narcotic analgesics can be prescribed at the same time in reduced doses.

For parenteral use in patients aged 16 to 64 years with a body weight exceeding 50 kg, no more than 60 mg is administered intramuscularly (including oral administration). Usually - 30 mg every 6 hours; IV - 30 mg (no more than 6 doses in 2 days).

In adult patients weighing less than 50 kg or with chronic renal failure, a single dose of no more than 30 mg is administered intramuscularly (including oral administration); usually - 15 mg (no more than 8 doses in 2 days); IV - no more than 15 mg every 6 hours (no more than 8 doses in 2 days).

The maximum daily doses for IM and IV administration are 90 mg/day for patients from 16 to 64 years old, with a body weight exceeding 50 kg; for adult patients weighing less than 50 kg or with chronic renal failure, as well as elderly patients (over 65 years old) for intramuscular and intravenous administration - 60 mg. The duration of treatment should not exceed 2 days.

When administered intravenously, the dose must be administered at least 15 seconds before. The IM injection is given slowly, deep into the muscle. The onset of the analgesic effect is noted after 30 minutes, maximum pain relief occurs after 1–2 hours. The analgesic effect lasts about 4–6 hours.

Description

Ketorol's active ingredient is ketorolac, a compound that pharmacists classify as a non-steroidal anti-inflammatory drug. As you know, non-steroidal anti-inflammatory drugs (NSAIDs) have three types of action - analgesic, antipyretic and anti-inflammatory. Moreover, not all such drugs exhibit these effects to the same extent. Some drugs are used primarily to reduce fever, others to fight inflammation.

Ketorolac is, one might say, a “specialist” among NSAIDs, dealing mainly only with counteracting pain. Its antipyretic and anti-inflammatory properties are rather weak. But in terms of analgesic effect, it surpasses all other non-steroidal drugs. Moreover, its action against pain can be compared with the action of recognized leaders among painkillers - drugs that excite opiate receptors of the central nervous system. Such drugs are also called narcotic analgesics. And among this group, ketorolac is only slightly inferior to morphine, one of the most famous and effective painkillers.

At the same time, ketorolac has a number of advantages compared to opiate analgesics. First of all, it does not cause drug dependence. In addition, ketorolac does not have an anxiolytic or sedative effect, does not depress the respiratory center, does not lead to urinary retention, and does not directly affect the cardiovascular system. All this means fewer contraindications and a wide range of application of the drug.

Mechanism of action

The principle of action of ketorolac, like NSAIDs, is based on blocking the biochemical chain consisting in the synthesis of inflammatory mediators - prostaglandins from arachidonic acid using a special enzyme - cyclooxygenase. And pain is usually caused by the effect of prostaglandins on nerve endings.

The analgesic effect of Ketorol occurs primarily in peripheral tissues. Ketorolac does not have a selective effect on cyclooxygenase; it blocks cyclooxygenase types 1 and 2 equally effectively. The drug's non-selectivity, however, means that it also reduces the amount of prostaglandins that protect the gastrointestinal tract and prostaglandins responsible for platelet aggregation. And this is fraught with side effects, especially with long-term use of the drug.

Ketorol recipe

Rp:Sol. "Ketoroli" 3% – 1 ml

Dtd10 amp.

S. Administer 1 ml intravenously or intramuscularly

The recipe for Ketorol tablets is as follows: Rp: Tab. "Ketoroli" 10 mgD.td 20 tabletaeS. Take 1 tablet orally every 8 hours.

In all of these recipes, after the letters “Rp,” the release form (Sol., Tab., Gel) and the name Ketorol in Latin are indicated in quotation marks, since it is commercial. The second line after the letters “Dtd” indicates how much of the drug the pharmacist at the pharmacy must dispense to the person presenting the prescription. In the third line after the letter "S." it is indicated for the person himself how to use the drug.

The main ways to combat pain with injections

In modern medicine, when it is necessary to eliminate back pain, preference is given to drugs from two groups: NSAIDs and neuroblockers.

It is important to understand that injections can only be a temporary measure, therefore, after relieving acute pain, it is necessary to use other treatment methods - therapeutic exercise, massage, physiotherapy, etc.

Doctors often prescribe combination medications containing B vitamins. It is believed that vitamin B12 has the greatest analgesic effect. Vitamins of this group contribute to the restoration of nerve fibers, normalize nervous and metabolic processes and have an overall positive effect on the nervous system.

However, the use of B vitamins as injections for back pain does not make sense if the pain occurs in an acute condition. If the disease causing discomfort is chronic or recurrent, the use of vitamin-based medications is ineffective.

In some cases, injections and stretching are used to combat particularly severe pain. The patient lies on his stomach, and injections with a novocaine solution are given at the points of most intense pain. In this case, the needle should enter strictly perpendicularly. Next, passive muscle stretching is performed, after which a hot compress is placed on the sore area. After removing the compress, the patient needs physical activity. It is required to move as much as possible, using the muscles of the painful area.

This blockade is used to prevent the nerve from transmitting painful impulses. It's like he switches off. For maximum effectiveness of the blockade, injections must be made as close to the exit points of the nerves as possible. Epidural blocks are most often prescribed for chronic back pain, such as a herniated disc.

Features of the drug's action

The basis for the therapeutic effect of the drug Ketorol, as a representative of the NSAID line, is considered to be the biochemical process of inhibition of a special substance. The enzyme cyclooxygenase promotes the conversion of arachidonic acid into components (prostaglandins) that trigger an inflammation reaction, the development of pain, and an increase in body temperature. Ketorolac, by blocking the action of cyclooxygenase, stops the synthesis of prostaglandins, resulting in the cessation of inflammation, pain syndrome, and increased temperature.

Due to its powerful analgesic effect, comparable to the analgesia of morphine, the drug is primarily used for pain relief; the anti-inflammatory and antipyretic effects are secondary. According to the instructions, one of the main advantages of the symptomatic use of Ketorol is the absence of the following consequences:

• anxiolytic and sedative effects;
• respiratory depression, as well as urinary retention;
• development of drug dependence;
• disorders of the cardiovascular system;
• effects on the functioning of opiate receptors.

Despite the benefits, the instructions for use of the drug warn that Ketorol injections should be prescribed with caution to people suffering from pathologies with a risk of bleeding. The medicine helps to thin the blood while reducing the activity of its coagulation, but without exceeding the normal limit.

Prices and analogues

Ketarol tablets: 20 pieces. 10 milligrams each, price 49 rubles.

Solution for intravenous administration: 30 milligrams/milliliter, 1 ampoules, ten pieces, price 127 rubles.

Ketorol gel 2%: 30 grams, price 229 rubles.

Analogues:

• acular LS, allergan - 330 rubles;
• Ketanov, Ranbaxy - 231 rubles;
• dolak, censer - 33 rubles;
• ketorolac, rompharm - 91 rubles.