Roket
Generic Name
Ketorolac Tromethamine
Manufacturer
The Acme Laboratories Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| roket 60 mg injection | ৳ 95.00 | N/A |
Description
Overview of the medicine
Roket 60 mg Injection contains Ketorolac Tromethamine, a potent NSAID used for the short-term management of moderate to severe acute pain. It is often used post-operatively or for other acute painful conditions when oral administration is not feasible.
Uses & Indications
Dosage
Adults
For IM/IV administration, initially 30 mg or 60 mg once, then 15 mg or 30 mg every 6 hours. Max 60 mg/day for patients 65 years and older or with renal impairment; max 120 mg/day for younger patients. Total treatment duration should not exceed 5 days.
Elderly
Lower doses are recommended, generally not exceeding 60 mg/day. Close monitoring for adverse effects is crucial.
Renal_impairment
Contraindicated in advanced renal impairment. For mild to moderate impairment, dosage reduction (e.g., max 60 mg/day) and close monitoring are necessary.
How to Take
For intramuscular (IM) or intravenous (IV) administration. IV bolus should be administered over a minimum of 15 seconds. IM injection should be given slowly and deeply into a large muscle mass. Not for epidural or intrathecal administration.
Mechanism of Action
Ketorolac inhibits prostaglandin synthesis by reversibly blocking cyclooxygenase (COX-1 and COX-2) enzymes. This reduces the formation of prostaglandins, which are mediators of pain, inflammation, and fever.
Pharmacokinetics
Onset
Analgesic effect begins within 30 minutes, peak effect within 1-2 hours.
Excretion
Primarily renal (kidney) excretion, with about 92% eliminated in urine (60% as unchanged drug and 40% as metabolites).
Half life
Approximately 4-6 hours (ranges from 2.5 to 9 hours depending on age and renal function).
Absorption
Rapidly and completely absorbed after intramuscular (IM) administration, reaching peak plasma concentrations within 45-60 minutes.
Metabolism
Primarily hepatic (liver) metabolism, mainly by glucuronidation.
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., hemophilia, anti-coagulant therapy)
- History of asthma, urticaria, or allergic-type reactions after aspirin or other NSAIDs
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
- Concomitant use with other NSAIDs, aspirin, probenecid, or pentoxifylline
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Probenecid
Significantly increases ketorolac plasma levels and half-life, contraindicated.
Methotrexate
Increased methotrexate toxicity.
Pentoxifylline
Increased risk of bleeding, contraindicated.
ACE inhibitors/ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Other NSAIDs and Aspirin
Increased risk of GI bleeding and ulceration.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effects.
Anticoagulants (e.g., Warfarin, Heparin)
Increased risk of bleeding.
Storage
Store below 30°C, protected from light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms may include epigastric pain, nausea, vomiting, lethargy, and drowsiness. Rare cases of GI bleeding, hypertension, acute renal failure, and respiratory depression. Management involves supportive care and symptomatic treatment. Gastric decontamination may be considered if ingestion was recent. Hemodialysis is not effective in removing ketorolac.
Pregnancy & Lactation
Pregnancy Category C (D in third trimester or near delivery). Avoid in late pregnancy due to potential for premature closure of ductus arteriosus and effects on labor. Not recommended during breastfeeding due to excretion into breast milk and potential adverse effects on the infant.
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., hemophilia, anti-coagulant therapy)
- History of asthma, urticaria, or allergic-type reactions after aspirin or other NSAIDs
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
- Concomitant use with other NSAIDs, aspirin, probenecid, or pentoxifylline
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Probenecid
Significantly increases ketorolac plasma levels and half-life, contraindicated.
Methotrexate
Increased methotrexate toxicity.
Pentoxifylline
Increased risk of bleeding, contraindicated.
ACE inhibitors/ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Other NSAIDs and Aspirin
Increased risk of GI bleeding and ulceration.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effects.
Anticoagulants (e.g., Warfarin, Heparin)
Increased risk of bleeding.
Storage
Store below 30°C, protected from light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms may include epigastric pain, nausea, vomiting, lethargy, and drowsiness. Rare cases of GI bleeding, hypertension, acute renal failure, and respiratory depression. Management involves supportive care and symptomatic treatment. Gastric decontamination may be considered if ingestion was recent. Hemodialysis is not effective in removing ketorolac.
Pregnancy & Lactation
Pregnancy Category C (D in third trimester or near delivery). Avoid in late pregnancy due to potential for premature closure of ductus arteriosus and effects on labor. Not recommended during breastfeeding due to excretion into breast milk and potential adverse effects on the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, refer to product packaging for specific expiry date.
Availability
Available in pharmacies, hospitals
Approval Status
Approved by relevant health authorities (e.g., DGDA in Bangladesh)
Patent Status
Generics available, patent expired for ketorolac
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of ketorolac for acute pain management. Ongoing research may explore specific patient populations or novel formulations.
Lab Monitoring
- Renal function (creatinine, BUN)
- Liver function (ALT, AST)
- Complete blood count (CBC) with differential, especially if prolonged use
- Blood pressure
Doctor Notes
- Emphasize short-term use (max 5 days) for acute pain.
- Carefully assess patients for GI, renal, and cardiovascular risk factors before prescribing.
- Monitor renal function, blood pressure, and signs of GI bleeding.
- Concomitant use of other NSAIDs or anticoagulants is strictly contraindicated.
- Avoid in patients with a history of asthma exacerbated by NSAIDs.
Patient Guidelines
- Inform your doctor about all current medications, especially blood thinners or other NSAIDs.
- Report any signs of unusual bleeding, black/tarry stools, or severe stomach pain immediately.
- Do not exceed the prescribed dose or duration of treatment (maximum 5 days).
- Avoid alcohol while taking this medicine.
- Inform your doctor if you have a history of heart disease, kidney disease, liver disease, or asthma.
Missed Dose Advice
Since this is an injection given by a healthcare professional, a missed dose is unlikely. If it happens in a clinical setting, contact your doctor or nurse immediately.
Driving Precautions
May cause dizziness, drowsiness, or visual disturbances. Patients should be cautioned against driving or operating machinery if they experience these effects.
Lifestyle Advice
- Maintain good hydration.
- Avoid activities that could lead to injury during the pain relief period.
- Follow up with your doctor as advised.
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