Ketorolac Tromethamine

Ketorolac Tromethamine is a non-steroidal anti-inflammatory drug (nsaid) — potent short-term analgesic medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

Ketorolac Tromethamine is used only for short-term (up to 5 days) moderate to severe acute pain, such as:

• Pain after surgery, including caesarean and orthopaedic operations
• Pain after dental extraction or dental surgery
• Kidney-stone pain (renal colic)
• Severe musculoskeletal injury pain
• Severe migraine attack (under medical supervision)

It is not for mild aches, chronic arthritis, long-term back pain or routine fever — safer options exist for those. Treatment often starts with the injection in hospital and continues with tablets.

The usual adult dose of Ketorolac Tromethamine tablets is 10 mg every 4 to 6 hours as needed, up to a maximum of 40 mg per day. The total duration of ketorolac — injection and tablets combined — must not exceed 5 days.

• Take with or after food with a full glass of water
• Elderly patients and those under 50 kg need lower doses
• Not recommended for children except under specialist hospital care

Never extend the course on your own. The dose, route and duration must be decided by a doctor, who will weigh your stomach, kidney and heart risks first.

Because it is such a strong NSAID, Ketorolac Tromethamine carries a higher risk of side effects than milder painkillers:

• Stomach pain, heartburn, nausea, indigestion
• Drowsiness, dizziness or headache
• Fluid retention and raised blood pressure
• Stomach or intestinal ulcers and bleeding — can occur even within a few days, especially in the elderly
• Kidney injury, particularly in dehydrated patients
• Increased bleeding tendency after surgery
• Allergic reactions, wheezing in aspirin-sensitive asthma

Seek urgent care for black stools, vomiting blood, severe stomach pain or reduced urine output.

Key precautions with Ketorolac Tromethamine:

• Never use it for more than 5 days in total — the risk of bleeding and kidney damage rises steeply after that
• Always take it with food and plenty of water
• Avoid completely in dengue or suspected dengue — serious bleeding risk; use paracetamol instead
• Avoid if dehydrated, and in the elderly use only at reduced doses under supervision
• Do not combine with any other NSAID, aspirin or steroid
• Use extreme caution with ulcer history, kidney disease, heart disease, hypertension, asthma or bleeding disorders
• Not for pain relief before or during major surgery without the surgical team's instruction

Important interactions of Ketorolac Tromethamine:

• Other NSAIDs, aspirin, corticosteroids — sharply increased ulcer and bleeding risk; never combine
• Anticoagulants and antiplatelets (warfarin, heparin, clopidogrel) — dangerous bleeding risk
• SSRIs (e.g. sertraline, escitalopram) — added GI bleeding risk
• ACE inhibitors, ARBs, diuretics — kidney injury risk, reduced blood-pressure control
• Lithium and methotrexate — levels rise, causing toxicity
• Probenecid — markedly raises ketorolac levels; combination contraindicated
• Pentoxifylline — increased bleeding tendency

Tell your doctor every medicine and supplement you are taking before starting.

Do not use Ketorolac Tromethamine if you have:

• Active or recent peptic ulcer or GI bleeding, or past NSAID-related bleeding
• Bleeding disorders, suspected cerebrovascular bleeding, or high bleeding risk after surgery
• Moderate to severe kidney impairment or risk of kidney failure from dehydration
• Severe heart failure or uncontrolled heart disease
• Asthma, urticaria or allergy triggered by aspirin or other NSAIDs
• Dengue fever or suspected dengue
• Pregnancy (especially third trimester), labour, delivery or breastfeeding without specialist advice
• Use as a painkiller before or during major surgery, unless directed by the surgical team

Pregnancy: Ketorolac Tromethamine should be avoided throughout pregnancy and is contraindicated in the third trimester and around delivery — it can close a vital vessel in the baby's heart prematurely, impair the baby's kidneys, delay labour and increase bleeding at delivery.

Breastfeeding: Ketorolac passes into breast milk in small amounts and many references advise avoiding it while breastfeeding, particularly with newborns. If strong pain relief is needed after caesarean delivery, use it only exactly as prescribed by your doctor, who may prefer safer alternatives.

Store Ketorolac Tromethamine below 30°C in a dry place, protected from light and moisture. Keep tablets in the original blister until use; store injections as directed on the label and protect them from light. Keep all medicines out of the reach and sight of children. Do not use after the expiry date on the pack.