Repopain
Generic Name
Ketorolac Tromethamine
Manufacturer
Hypothetical Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| repopain 30 mg injection | ৳ 55.00 | N/A |
Description
Overview of the medicine
Repopain 30 mg Injection contains Ketorolac Tromethamine, a potent non-steroidal anti-inflammatory drug (NSAID) used for the short-term management of moderately severe acute pain requiring opioid-level analgesia.
Uses & Indications
Dosage
Adults
Initial dose 30 mg IM or IV, followed by 10-30 mg every 4-6 hours as needed, not exceeding 120 mg/day. Treatment duration should not exceed 5 days.
Elderly
Reduced dosage (e.g., 15 mg every 4-6 hours), not exceeding 60 mg/day, due to increased risk of side effects.
Renal_impairment
Significant reduction required. Not recommended in severe renal impairment. For moderate impairment, dose reduction to 15 mg every 6 hours, not exceeding 60 mg/day.
How to Take
Administer intramuscularly (IM) slowly and deeply into a large muscle or intravenously (IV) as a bolus over at least 15 seconds. Should not be administered epidurally or intrathecally.
Mechanism of Action
Ketorolac inhibits prostaglandin synthesis by reversibly blocking cyclooxygenase (COX-1 and COX-2) enzymes, thereby reducing pain and inflammation.
Pharmacokinetics
Onset
Within 30 minutes (IM/IV)
Excretion
Mainly renal (kidneys), with about 92% excreted in urine and 6% in feces.
Half life
Approximately 5-6 hours
Absorption
Rapid and complete absorption after intramuscular (IM) administration, reaching peak plasma concentrations within 30-60 minutes.
Metabolism
Primarily hepatic (liver) via glucuronidation and hydroxylation.
Side Effects
Contraindications
- Hypersensitivity to ketorolac or other NSAIDs
- Active peptic ulcer, gastrointestinal bleeding, or perforation
- Advanced renal impairment
- Patients at risk of bleeding (e.g., coagulopathy)
- Concomitant use with other NSAIDs, aspirin, or probenecid
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
- Pregnancy (especially third trimester) and lactation
Drug Interactions
Lithium
Increased lithium plasma levels and potential for toxicity.
Probenecid
Increased ketorolac plasma levels and half-life.
Methotrexate
Increased methotrexate toxicity.
ACE Inhibitors/ARBs
Reduced antihypertensive effect, increased risk of renal impairment.
Other NSAIDs/Aspirin
Increased risk of gastrointestinal adverse effects.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effect, increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Storage
Store below 30°C, protected from light and moisture. Do not freeze.
Overdose
Symptoms may include nausea, vomiting, epigastric pain, lethargy, drowsiness, and GI bleeding. In severe cases, hypertension, acute renal failure, respiratory depression, and coma may occur. Treatment is primarily symptomatic and supportive, including gastric lavage (if recent oral ingestion) and monitoring of vital signs and renal function.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester due to potential fetal harm (e.g., premature closure of ductus arteriosus). Avoid during lactation as ketorolac is excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to ketorolac or other NSAIDs
- Active peptic ulcer, gastrointestinal bleeding, or perforation
- Advanced renal impairment
- Patients at risk of bleeding (e.g., coagulopathy)
- Concomitant use with other NSAIDs, aspirin, or probenecid
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
- Pregnancy (especially third trimester) and lactation
Drug Interactions
Lithium
Increased lithium plasma levels and potential for toxicity.
Probenecid
Increased ketorolac plasma levels and half-life.
Methotrexate
Increased methotrexate toxicity.
ACE Inhibitors/ARBs
Reduced antihypertensive effect, increased risk of renal impairment.
Other NSAIDs/Aspirin
Increased risk of gastrointestinal adverse effects.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effect, increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Storage
Store below 30°C, protected from light and moisture. Do not freeze.
Overdose
Symptoms may include nausea, vomiting, epigastric pain, lethargy, drowsiness, and GI bleeding. In severe cases, hypertension, acute renal failure, respiratory depression, and coma may occur. Treatment is primarily symptomatic and supportive, including gastric lavage (if recent oral ingestion) and monitoring of vital signs and renal function.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester due to potential fetal harm (e.g., premature closure of ductus arteriosus). Avoid during lactation as ketorolac is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date
Availability
Hospitals, Clinics, Pharmacies
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of Ketorolac for short-term acute pain management.
Lab Monitoring
- Renal function (BUN, creatinine)
- Liver function tests (ALT, AST)
- Complete blood count (CBC) with differential if long-term use is anticipated
- Coagulation parameters (PT, aPTT) if used with anticoagulants or in patients with bleeding risk.
Doctor Notes
- Strictly adhere to the maximum treatment duration of 5 days.
- Assess renal function prior to initiation and periodically during treatment, especially in elderly or renally impaired patients.
- Monitor for signs of GI bleeding and cardiovascular adverse events.
- Not for use in obstetric analgesia or children under 16 years of age.
Patient Guidelines
- Inform your doctor about all current medications, including over-the-counter drugs and herbal supplements.
- Do not exceed the prescribed dose or duration of treatment (maximum 5 days).
- Report any signs of gastrointestinal bleeding (e.g., black, tarry stools, vomiting blood) or allergic reactions immediately.
- Avoid alcohol consumption during treatment.
- This medication is for short-term acute pain relief only.
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 cautioned about operating machinery or driving until they know how Repopain affects them.
Lifestyle Advice
- Maintain adequate hydration.
- Avoid activities requiring mental alertness if dizziness or drowsiness occurs.
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