Doltro
Generic Name
Ketorolac Tromethamine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| doltro 30 mg injection | ৳ 60.00 | N/A |
Description
Overview of the medicine
Doltro 30 mg Injection contains Ketorolac Tromethamine, a non-steroidal anti-inflammatory drug (NSAID), used for the short-term management of moderate to severe acute pain, often post-operative.
Uses & Indications
Dosage
Adults
Initial dose: 30 mg IM or IV as a single dose. Maintenance: 30 mg IM or IV every 6 hours, not to exceed 120 mg/day for a maximum of 5 days.
Elderly
For patients ≥65 years, or with renal impairment or body weight <50 kg: 15 mg IM or IV every 6 hours, not to exceed 60 mg/day for a maximum of 5 days.
Renal_impairment
Reduced dosage (e.g., 15 mg every 6 hours) is required for mild renal impairment. Contraindicated in moderate to severe renal impairment.
How to Take
Administer intramuscularly (IM) into a large muscle or intravenously (IV) slowly over at least 15 seconds. May be administered as a continuous IV infusion in diluted solution.
Mechanism of Action
Ketorolac inhibits prostaglandin synthesis by non-selectively inhibiting cyclooxygenase (COX-1 and COX-2) enzymes, thereby reducing pain, inflammation, and fever.
Pharmacokinetics
Onset
Analgesic onset: IM: 10 minutes; IV: less than 1 minute.
Excretion
Mainly renal (approximately 92% excreted in urine as unchanged drug and metabolites), with a small amount (6%) excreted in feces.
Half life
Mean terminal half-life is approximately 4-6 hours in healthy adults, but varies with age and renal function.
Absorption
Rapid and complete absorption after intramuscular (IM) and intravenous (IV) administration. Peak plasma concentrations reached within 30-50 minutes after IM.
Metabolism
Primarily hepatic, mainly through glucuronidation and some hydroxylation. Metabolites are largely inactive.
Side Effects
Contraindications
- •Hypersensitivity to Ketorolac, aspirin, or other NSAIDs
- •Active peptic ulcer disease, recent gastrointestinal bleeding or perforation
- •Advanced renal impairment or at risk of renal failure due to volume depletion
- •Suspected or confirmed cerebrovascular bleeding, hemorrhagic diathesis
- •As prophylactic analgesic before major surgery or intraoperatively (due to inhibition of platelet function)
- •Concomitant use with other NSAIDs, aspirin, anticoagulants, pentoxifylline, probenecid, or lithium
- •During labor and delivery (due to inhibition of uterine contractions and increased risk of bleeding)
Drug Interactions
Lithium
Ketorolac can decrease renal clearance of lithium, leading to increased plasma lithium levels and potential toxicity.
Probenecid
Increased plasma levels and half-life of Ketorolac.
Methotrexate
Increased methotrexate toxicity by reducing its renal clearance.
Pentoxifylline
Increased risk of bleeding.
ACE Inhibitors/ARBs
May diminish the antihypertensive effect and increase the risk of renal impairment, especially in dehydrated patients.
Other NSAIDs or Aspirin
Increased risk of gastrointestinal side effects including ulcers and bleeding.
Diuretics (e.g., Furosemide)
Reduced natriuretic and diuretic effects of loop diuretics.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding due to additive antiplatelet effects and potential displacement from plasma protein binding.
Storage
Store below 30°C in a dry place, protected from light. Do not freeze.
Overdose
Symptoms of overdose may include abdominal pain, nausea, vomiting, hyperventilation, peptic ulcer, and/or erosive gastritis. Supportive care is generally recommended. Gastric lavage may be considered if recent ingestion occurred. Renal dialysis does not significantly clear Ketorolac from the blood.
Pregnancy & Lactation
Pregnancy Category C (first and second trimesters), Category D (third trimester). Contraindicated in late pregnancy due to potential for premature closure of the ductus arteriosus and inhibition of uterine contractions. Use with caution during lactation as Ketorolac is excreted in breast milk; a decision should be made whether to discontinue nursing or the drug, considering the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, specific details on packaging.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesAlternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine
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