Nugesic
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 |
|---|---|---|
| nugesic 100 mg injection | ৳ 25.17 | N/A |
Description
Overview of the medicine
Nugesic 100 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. It provides potent analgesic effects.
Uses & Indications
Dosage
Adults
For acute pain, usually 30 mg to 60 mg IM or IV as a single dose, or 30 mg IV/IM every 6 hours. Maximum daily dose is generally 120 mg. *Note: 100 mg as a single dose is generally higher than recommended for Ketorolac in standard guidelines, consult prescribing information for specific product.*
Elderly
Lower doses are recommended, typically 15 mg to 30 mg IM or IV every 6 hours. Maximum daily dose 60 mg. Adjust based on renal function.
Renal_impairment
Contraindicated in advanced renal impairment. For mild to moderate impairment, dose reduction is necessary; typically, maximum daily dose should not exceed 60 mg. Regular monitoring of renal function is essential.
How to Take
Administered by intravenous (IV) or intramuscular (IM) injection. IV doses should be administered slowly over at least 15 seconds. Ensure aseptic technique during administration.
Mechanism of Action
Ketorolac inhibits prostaglandin synthesis by non-selectively blocking the cyclooxygenase (COX-1 and COX-2) enzymes. Prostaglandins are mediators of inflammation, pain, and fever, so their inhibition leads to analgesic, anti-inflammatory, and antipyretic effects.
Pharmacokinetics
Onset
Approximately 30 minutes (IM), rapid (IV)
Excretion
Mainly renal, about 91% of the dose excreted in urine (60% as unchanged drug, 37% as metabolites). Fecal excretion accounts for about 6%.
Half life
About 4-6 hours (range 3.8-8.6 hours)
Absorption
Rapid and complete absorption after intramuscular (IM) administration. Peak plasma concentrations are achieved within 45-60 minutes after IM dose.
Metabolism
Primarily hepatic, mainly by glucuronidation. A minor portion is hydroxylated.
Side Effects
Contraindications
- •Known hypersensitivity to Ketorolac or other NSAIDs
- •Active peptic ulcer, gastrointestinal bleeding or perforation
- •Advanced renal impairment
- •History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- •Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
- •Concomitant use with other NSAIDs, aspirin, anticoagulants (e.g., warfarin), or probenecid
- •Pregnancy (especially third trimester) and lactation
- •Patients at high risk of bleeding
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Probenecid
Increased plasma levels and half-life of Ketorolac. Concomitant use is contraindicated.
Methotrexate
Increased methotrexate toxicity.
ACE inhibitors/ARBs
Increased risk of renal impairment, especially in elderly or dehydrated patients.
Other NSAIDs or Aspirin
Increased risk of gastrointestinal adverse effects and bleeding. Concomitant use is contraindicated.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effects, potential for renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding. Concomitant use is contraindicated.
Storage
Store below 30°C, protected from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of overdose may include abdominal pain, nausea, vomiting, lethargy, drowsiness, and epigastric pain. Rare symptoms include gastrointestinal bleeding, hypertension, acute renal failure, and respiratory depression. Management involves symptomatic and supportive care. Gastric decontamination is generally not indicated for parenteral overdose. Hemodialysis does not significantly clear Ketorolac from the blood.
Pregnancy & Lactation
Pregnancy Category C (first and second trimesters), Category D (third trimester). Contraindicated during late pregnancy due to potential for premature closure of ductus arteriosus and impaired renal function in the fetus. Should be avoided during lactation as Ketorolac is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the date of manufacture, specific details on packaging.
Availability
Pharmacies, Hospitals, Clinics
Approval Status
Approved by FDA (for Ketorolac) and DGDA (in Bangladesh)
Patent Status
Generic available, original patent expired
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Global Brand Names
International brand names for this medicine
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