Maxdol
Generic Name
Ketorolac Tromethamine 30 mg Injection
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| maxdol 30 mg injection | ৳ 55.00 | N/A |
Description
Overview of the medicine
Maxdol 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. It is often used post-operatively or for acute musculoskeletal pain where opioid analgesics are not appropriate or desirable.
Uses & Indications
Dosage
Adults
Initially 30 mg IM or IV single dose, or 30 mg every 6 hours (max 120 mg/day) for short-term acute pain. Duration of treatment should not exceed 5 days.
Elderly
Lower doses recommended, e.g., 15 mg IM or IV every 6 hours (max 60 mg/day).
Renal_impairment
Reduced dosage required; contraindicated in severe renal impairment.
How to Take
For intramuscular (IM) or intravenous (IV) administration. IV bolus should be administered over at least 15 seconds. IM injection should be given slowly and deeply into a large muscle mass.
Mechanism of Action
Ketorolac works by inhibiting the synthesis of prostaglandins by blocking the cyclooxygenase (COX-1 and COX-2) enzymes. Prostaglandins are mediators of pain, inflammation, and fever.
Pharmacokinetics
Onset
Within 10 minutes (IV), 30 minutes (IM)
Excretion
Approximately 92% of the dose is excreted in urine, with the remainder excreted in feces. Renal excretion is the primary route.
Half life
Approximately 5-6 hours in healthy adults.
Absorption
Rapid and complete absorption after intramuscular (IM) administration. Peak plasma concentrations are reached within 30-60 minutes.
Metabolism
Primarily hepatic, largely by glucuronidation.
Side Effects
Contraindications
- Known hypersensitivity to ketorolac or other NSAIDs (e.g., aspirin-induced asthma, urticaria, or other allergic-type reactions).
- Active peptic ulcer, recent gastrointestinal bleeding or perforation, or a history of these conditions.
- Advanced renal impairment or at risk of renal failure due to volume depletion.
- Coagulation disorders or patients receiving anticoagulants (e.g., warfarin).
- Cerebrovascular bleeding or patients at high risk of bleeding.
- During labor and delivery, due to potential adverse effects on fetal circulation and inhibition of uterine contractions.
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Methotrexate
Increased methotrexate levels, leading to toxicity.
ACE inhibitors/ARBs
Increased risk of renal impairment, especially in dehydrated patients.
Other NSAIDs/Aspirin
Increased risk of GI side effects and bleeding.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effects.
Anticoagulants (e.g., Warfarin, Heparin)
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, protected from light. Do not freeze.
Overdose
Symptoms may include epigastric pain, nausea, vomiting, GI bleeding, lethargy, drowsiness, or anaphylactoid reactions. Management is primarily supportive. Gastric lavage or activated charcoal may be considered if recent ingestion. Hemodialysis does not significantly remove ketorolac.
Pregnancy & Lactation
Pregnancy Category C (first and second trimester), Category D (third trimester). Avoid in late pregnancy due to potential for premature closure of ductus arteriosus. Use with caution during breastfeeding; small amounts excreted in breast milk.
Side Effects
Contraindications
- Known hypersensitivity to ketorolac or other NSAIDs (e.g., aspirin-induced asthma, urticaria, or other allergic-type reactions).
- Active peptic ulcer, recent gastrointestinal bleeding or perforation, or a history of these conditions.
- Advanced renal impairment or at risk of renal failure due to volume depletion.
- Coagulation disorders or patients receiving anticoagulants (e.g., warfarin).
- Cerebrovascular bleeding or patients at high risk of bleeding.
- During labor and delivery, due to potential adverse effects on fetal circulation and inhibition of uterine contractions.
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Methotrexate
Increased methotrexate levels, leading to toxicity.
ACE inhibitors/ARBs
Increased risk of renal impairment, especially in dehydrated patients.
Other NSAIDs/Aspirin
Increased risk of GI side effects and bleeding.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effects.
Anticoagulants (e.g., Warfarin, Heparin)
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, protected from light. Do not freeze.
Overdose
Symptoms may include epigastric pain, nausea, vomiting, GI bleeding, lethargy, drowsiness, or anaphylactoid reactions. Management is primarily supportive. Gastric lavage or activated charcoal may be considered if recent ingestion. Hemodialysis does not significantly remove ketorolac.
Pregnancy & Lactation
Pregnancy Category C (first and second trimester), Category D (third trimester). Avoid in late pregnancy due to potential for premature closure of ductus arteriosus. Use with caution during breastfeeding; small amounts excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, refer to product packaging for specific dates.
Availability
Pharmacies, Hospitals, Clinics
Approval Status
Approved by regulatory authorities
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Ketorolac has undergone extensive clinical trials demonstrating its efficacy in acute pain management. Ongoing research explores its comparative effectiveness and safety profile against other analgesics.
Lab Monitoring
- Complete Blood Count (CBC)
- Renal function tests (Creatinine, BUN)
- Liver function tests (ALT, AST)
- Stool for occult blood if GI concerns
Doctor Notes
- Emphasize the 5-day maximum duration due to increased risk of serious adverse events.
- Consider patient's renal function and GI history before prescribing.
- Not suitable for chronic pain management.
Patient Guidelines
- Inform your doctor about all existing medical conditions and current medications.
- Report any signs of unusual bleeding, dark stools, or severe stomach pain immediately.
- Do not use for more than 5 days for acute pain due to increased risk of side effects.
- Avoid alcohol while taking this medication as it may increase the risk of stomach bleeding.
Missed Dose Advice
If a dose is missed, administer it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness or drowsiness. Patients should be cautious when driving or operating machinery until they know how the drug affects them.
Lifestyle Advice
- Maintain adequate hydration.
- Avoid activities requiring mental alertness if experiencing dizziness or drowsiness.
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