Ditrolac
Generic Name
Ketorolac Tromethamine
Manufacturer
Renata Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ditrolac 10 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Ditrolac 10 mg Tablet contains Ketorolac Tromethamine, a non-steroidal anti-inflammatory drug (NSAID) used for the short-term management of moderately severe acute pain. It should not be used for chronic pain.
Uses & Indications
Dosage
Adults
Oral: 10 mg every 4 to 6 hours as needed, not to exceed 40 mg in 24 hours. Maximum duration of treatment is 5 days.
Elderly
Lower doses (e.g., 10 mg every 6-8 hours) should be used, with careful monitoring for adverse effects, especially renal impairment.
Renal_impairment
Contraindicated in patients with moderate to severe renal impairment. In mild impairment, reduce dose and monitor renal function closely.
How to Take
Take Ditrolac 10 mg Tablet orally with food or milk to minimize gastrointestinal upset. Swallow the tablet whole with a glass of water.
Mechanism of Action
Ketorolac works by inhibiting the activity of cyclooxygenase (COX-1 and COX-2) enzymes, which are responsible for the synthesis of prostaglandins. Prostaglandins play a key role in pain, inflammation, and fever.
Pharmacokinetics
Onset
Oral: Approximately 30-60 minutes.
Excretion
Mainly excreted by the kidneys (approximately 91% of the dose), with a smaller portion excreted in the feces (approximately 6%).
Half life
Approximately 5-6 hours in healthy adults, but can be prolonged in elderly or renally impaired patients.
Absorption
Rapidly and completely absorbed after oral administration. Peak plasma concentrations are achieved within 30-60 minutes.
Metabolism
Primarily metabolized in the liver, mainly through hydroxylation and conjugation reactions.
Side Effects
Contraindications
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Active peptic ulcer disease or gastrointestinal bleeding
- Advanced renal impairment
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
- Concomitant use with other NSAIDs, aspirin, anticoagulants, or probenecid
- Pregnancy (especially third trimester) and lactation
- Hypersensitivity to ketorolac or any component of the formulation
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Methotrexate
Increased methotrexate toxicity.
ACE inhibitors/ARBs
Increased risk of renal impairment, especially in dehydrated patients.
Other NSAIDs/Aspirin
Increased risk of GI adverse events.
Diuretics (e.g., Furosemide)
Reduced diuretic effect and increased risk of renal toxicity.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include nausea, vomiting, epigastric pain, lethargy, and gastrointestinal bleeding. Management is symptomatic and supportive; there is no specific antidote. Consider gastric lavage and activated charcoal if recent ingestion.
Pregnancy & Lactation
Pregnancy Category C/D (D in 3rd trimester or near delivery). Avoid use during late pregnancy due to potential effects on fetal cardiovascular system. Avoid during lactation as ketorolac passes into breast milk.
Side Effects
Contraindications
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Active peptic ulcer disease or gastrointestinal bleeding
- Advanced renal impairment
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
- Concomitant use with other NSAIDs, aspirin, anticoagulants, or probenecid
- Pregnancy (especially third trimester) and lactation
- Hypersensitivity to ketorolac or any component of the formulation
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Methotrexate
Increased methotrexate toxicity.
ACE inhibitors/ARBs
Increased risk of renal impairment, especially in dehydrated patients.
Other NSAIDs/Aspirin
Increased risk of GI adverse events.
Diuretics (e.g., Furosemide)
Reduced diuretic effect and increased risk of renal toxicity.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include nausea, vomiting, epigastric pain, lethargy, and gastrointestinal bleeding. Management is symptomatic and supportive; there is no specific antidote. Consider gastric lavage and activated charcoal if recent ingestion.
Pregnancy & Lactation
Pregnancy Category C/D (D in 3rd trimester or near delivery). Avoid use during late pregnancy due to potential effects on fetal cardiovascular system. Avoid during lactation as ketorolac passes into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24 to 36 months from the date of manufacture. Check the expiry date on the packaging.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Ketorolac has undergone extensive clinical trials demonstrating its efficacy in managing acute pain. Studies support its use for short-term pain relief with careful consideration of its safety profile.
Lab Monitoring
- Renal function (serum creatinine, BUN) before and during treatment
- Liver function tests (ALT, AST) periodically
- Complete blood count (CBC) if used for more than 5 days or if signs of bleeding occur
- Stool occult blood tests
Doctor Notes
- Emphasize the strict 5-day maximum duration of treatment due to high risk of adverse effects.
- Carefully assess patients for GI, cardiovascular, and renal risk factors before initiation.
- Consider a proton pump inhibitor (PPI) or H2 blocker in high-risk patients if NSAID use is unavoidable.
- Avoid concomitant use with other NSAIDs or anticoagulants.
Patient Guidelines
- Do not exceed the recommended dose or duration of 5 days.
- Take with food or milk to minimize stomach upset.
- Report any unusual bleeding, stomach pain, black stools, or yellowing of the skin/eyes to your doctor immediately.
- Avoid alcohol while taking this medicine.
- Do not take other NSAIDs or aspirin concurrently without consulting your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Ditrolac may cause dizziness, drowsiness, or visual disturbances. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Stay well hydrated, especially if you are elderly or have pre-existing kidney conditions.
- Avoid excessive alcohol consumption.
- Inform your doctor about all other medications and supplements you are taking.
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