Rolac
Generic Name
Ketorolac Tromethamine
Manufacturer
Specific Manufacturer (e.g., Square Pharmaceuticals Ltd.)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| rolac 30 mg injection | ৳ 55.21 | N/A |
Description
Overview of the medicine
Ketorolac 30 mg injection is used for the short-term (up to 5 days) management of moderate to severe acute pain.
Uses & Indications
Dosage
Adults
Initial dose 30 mg IM or IV once, then 15-30 mg every 6 hours as needed. Maximum daily dose 120 mg. Do not exceed 5 days of treatment.
Elderly
For patients ≥65 years, renal impairment, or body weight <50 kg: 15 mg IM or IV every 6 hours. Maximum daily dose 60 mg. Do not exceed 5 days of treatment.
Renal_impairment
Significant dose reduction required. Contraindicated in advanced renal disease. For mild impairment, consider 15 mg every 6 hours, max 60 mg/day.
How to Take
Administered by intramuscular (IM) or intravenous (IV) injection. IV bolus should be given over at least 15 seconds. Should not be given epidurally or intrathecally.
Mechanism of Action
Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) that works by inhibiting the synthesis of prostaglandins, which are chemicals in the body that cause pain, fever, and inflammation. It achieves this by inhibiting cyclooxygenase (COX-1 and COX-2) enzymes.
Pharmacokinetics
Onset
Analgesia typically begins within 30-60 minutes.
Excretion
Excreted mainly in the urine (approximately 92%), with a small amount excreted in feces (approximately 6%).
Half life
Approximately 5.3 hours (range 3.5 to 9.2 hours) in healthy adults.
Absorption
Rapid and complete absorption after intramuscular (IM) or intravenous (IV) administration.
Metabolism
Primarily hepatic via hydroxylation and conjugation. The main metabolite is p-hydroxyketorolac.
Side Effects
Contraindications
- Active peptic ulcer disease, recent gastrointestinal bleeding or perforation, or history of such conditions.
- Advanced renal impairment or risk of renal failure due to volume depletion.
- History of asthma, urticaria, or allergic-type reactions after aspirin or other NSAIDs.
- Concomitant use with other NSAIDs, aspirin, anticoagulants (e.g., warfarin), or probenecid.
- Cerebrovascular bleeding or bleeding diathesis.
- Prior to surgery (due to increased risk of bleeding).
- Pregnancy (especially in the third trimester) and lactation.
- Hypersensitivity to ketorolac or any excipients.
Drug Interactions
Lithium
Increased plasma lithium levels, potentially leading to toxicity.
Probenecid
Increased plasma levels of ketorolac (contraindicated).
Methotrexate
Increased plasma methotrexate levels, potentially leading to toxicity.
Pentoxifylline
Increased risk of bleeding.
ACE Inhibitors/ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Other NSAIDs and Corticosteroids
Increased risk of gastrointestinal side effects, including ulceration and bleeding.
Diuretics (e.g., Furosemide, Thiazides)
Reduced diuretic and antihypertensive effects; increased risk of renal impairment.
Antiplatelet agents (e.g., Aspirin, Clopidogrel)
Increased risk of bleeding.
Storage
Store at controlled room temperature (20°C to 25°C), protect from light. Do not freeze.
Overdose
Symptoms of overdose include abdominal pain, nausea, vomiting, hyperventilation, headache, drowsiness, and occasionally diarrhea. Rare cases of severe gastrointestinal bleeding, renal failure, hypertension, and anaphylactoid reactions. Management is primarily supportive; there is no specific antidote.
Pregnancy & Lactation
Contraindicated during late pregnancy due to potential effects on fetal cardiovascular system (premature closure of ductus arteriosus) and inhibition of uterine contractions. Avoid during breastfeeding as it is excreted in breast milk.
Side Effects
Contraindications
- Active peptic ulcer disease, recent gastrointestinal bleeding or perforation, or history of such conditions.
- Advanced renal impairment or risk of renal failure due to volume depletion.
- History of asthma, urticaria, or allergic-type reactions after aspirin or other NSAIDs.
- Concomitant use with other NSAIDs, aspirin, anticoagulants (e.g., warfarin), or probenecid.
- Cerebrovascular bleeding or bleeding diathesis.
- Prior to surgery (due to increased risk of bleeding).
- Pregnancy (especially in the third trimester) and lactation.
- Hypersensitivity to ketorolac or any excipients.
Drug Interactions
Lithium
Increased plasma lithium levels, potentially leading to toxicity.
Probenecid
Increased plasma levels of ketorolac (contraindicated).
Methotrexate
Increased plasma methotrexate levels, potentially leading to toxicity.
Pentoxifylline
Increased risk of bleeding.
ACE Inhibitors/ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Other NSAIDs and Corticosteroids
Increased risk of gastrointestinal side effects, including ulceration and bleeding.
Diuretics (e.g., Furosemide, Thiazides)
Reduced diuretic and antihypertensive effects; increased risk of renal impairment.
Antiplatelet agents (e.g., Aspirin, Clopidogrel)
Increased risk of bleeding.
Storage
Store at controlled room temperature (20°C to 25°C), protect from light. Do not freeze.
Overdose
Symptoms of overdose include abdominal pain, nausea, vomiting, hyperventilation, headache, drowsiness, and occasionally diarrhea. Rare cases of severe gastrointestinal bleeding, renal failure, hypertension, and anaphylactoid reactions. Management is primarily supportive; there is no specific antidote.
Pregnancy & Lactation
Contraindicated during late pregnancy due to potential effects on fetal cardiovascular system (premature closure of ductus arteriosus) and inhibition of uterine contractions. Avoid during breastfeeding as it is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies and hospitals with a prescription
Approval Status
Approved by FDA/DGDA for short-term use
Patent Status
Off-patent (Generic available)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established ketorolac's efficacy and safety for short-term acute pain management. Ongoing research may explore specific patient populations or alternative administration routes.
Lab Monitoring
- Renal function (serum creatinine, BUN) before and during treatment.
- Liver function tests (ALT, AST) if treatment is prolonged or liver dysfunction is suspected.
- Complete Blood Count (CBC) with differential if signs of bleeding or anemia develop.
Doctor Notes
- Emphasize the strict 5-day maximum duration of use due to significant risks.
- Carefully assess renal function before initiating and during treatment, especially in elderly or volume-depleted patients.
- Avoid concomitant use with other NSAIDs, aspirin, or anticoagulants. Screen for GI bleeding risk factors.
- Use the lowest effective dose for the shortest possible duration.
Patient Guidelines
- Inform your doctor about all existing medical conditions, especially heart, kidney, or liver problems, and any history of ulcers or bleeding.
- Do not exceed the recommended dose or duration of treatment (maximum 5 days).
- Report any unusual bleeding, severe stomach pain, black/tarry stools, or swelling immediately.
- Avoid taking other NSAIDs or aspirin while on this medication unless specifically directed by your doctor.
Missed Dose Advice
Since this medicine is given on a fixed schedule in a medical setting, a missed dose is unlikely. If a dose is missed, inform your doctor or nurse immediately.
Driving Precautions
This medication may cause dizziness, drowsiness, or visual disturbances. Exercise caution when driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Avoid alcohol consumption while on this medication as it may increase the risk of stomach bleeding.
- Maintain adequate hydration, especially if you have renal concerns.
- Report any new or worsening symptoms to your healthcare provider.
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