Sanoket
Generic Name
Ketorolac Tromethamine
Manufacturer
ACI Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sanoket 60 mg injection | ৳ 95.29 | N/A |
Description
Overview of the medicine
Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) used for the short-term management of moderate to severe acute pain. It works by reducing hormones that cause pain and inflammation in the body.
Uses & Indications
Dosage
Adults
Single IM or IV dose: 30 mg or 60 mg. Multiple dose: 30 mg every 6 hours, not exceeding 120 mg/day for IM or IV. Max duration of therapy is 5 days.
Elderly
Reduced dose; 15 mg every 6 hours, not exceeding 60 mg/day for IM or IV.
Renal_impairment
Significantly reduced dose or 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.
Mechanism of Action
Ketorolac inhibits prostaglandin synthesis by reversibly blocking cyclooxygenase (COX-1 and COX-2) enzymes. This results in reduced inflammation, pain, and fever.
Pharmacokinetics
Onset
Analgesia begins within 30 minutes, peak effect within 1-2 hours.
Excretion
Primarily renal (approximately 90%), with some fecal excretion.
Half life
Approximately 4-6 hours (variable with renal function).
Absorption
Rapidly and completely absorbed after intramuscular (IM) or intravenous (IV) administration. Peak plasma concentration achieved in 30-60 minutes after IM.
Metabolism
Primarily hepatic via glucuronidation and hydroxylation.
Side Effects
Contraindications
- Hypersensitivity to ketorolac, aspirin, or other NSAIDs.
- Active peptic ulcer, gastrointestinal bleeding, or perforation.
- Moderate to severe renal impairment or risk of renal failure.
- History of asthma, urticaria, or allergic-type reactions after aspirin or other NSAIDs.
- Coagulation disorders, including those on anticoagulants.
- Cerebrovascular bleeding.
- Pregnancy (especially third trimester), labor, and delivery.
- As prophylactic analgesic before major surgery or during surgery.
- Children under 16 years of age.
Drug Interactions
Lithium
Increased plasma lithium levels.
SSRIs/SNRIs
Increased risk of GI bleeding.
Methotrexate
Increased methotrexate toxicity.
ACE inhibitors/ARBs
Decreased antihypertensive effect, increased risk of renal impairment.
Other NSAIDs/Aspirin
Increased risk of GI adverse events.
Diuretics (e.g., Furosemide)
Reduced natriuretic effect, risk of renal impairment.
Anticoagulants (e.g., Warfarin, Heparin)
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, away from light. Do not freeze.
Overdose
Symptoms may include lethargy, drowsiness, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. Rare symptoms include hypertension, acute renal failure, respiratory depression, and coma. Treatment is symptomatic and supportive; no specific antidote.
Pregnancy & Lactation
Pregnancy: Contraindicated in the third trimester. Use in early pregnancy only if potential benefit justifies potential risk to fetus. Avoid during labor and delivery due to potential for premature closure of ductus arteriosus and inhibition of uterine contractions. Lactation: Small amounts of ketorolac are excreted in breast milk. Use is not recommended during breastfeeding.
Side Effects
Contraindications
- Hypersensitivity to ketorolac, aspirin, or other NSAIDs.
- Active peptic ulcer, gastrointestinal bleeding, or perforation.
- Moderate to severe renal impairment or risk of renal failure.
- History of asthma, urticaria, or allergic-type reactions after aspirin or other NSAIDs.
- Coagulation disorders, including those on anticoagulants.
- Cerebrovascular bleeding.
- Pregnancy (especially third trimester), labor, and delivery.
- As prophylactic analgesic before major surgery or during surgery.
- Children under 16 years of age.
Drug Interactions
Lithium
Increased plasma lithium levels.
SSRIs/SNRIs
Increased risk of GI bleeding.
Methotrexate
Increased methotrexate toxicity.
ACE inhibitors/ARBs
Decreased antihypertensive effect, increased risk of renal impairment.
Other NSAIDs/Aspirin
Increased risk of GI adverse events.
Diuretics (e.g., Furosemide)
Reduced natriuretic effect, risk of renal impairment.
Anticoagulants (e.g., Warfarin, Heparin)
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, away from light. Do not freeze.
Overdose
Symptoms may include lethargy, drowsiness, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. Rare symptoms include hypertension, acute renal failure, respiratory depression, and coma. Treatment is symptomatic and supportive; no specific antidote.
Pregnancy & Lactation
Pregnancy: Contraindicated in the third trimester. Use in early pregnancy only if potential benefit justifies potential risk to fetus. Avoid during labor and delivery due to potential for premature closure of ductus arteriosus and inhibition of uterine contractions. Lactation: Small amounts of ketorolac are excreted in breast milk. Use is not recommended during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24-36 months when stored properly.
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory bodies like DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensively studied in numerous clinical trials for acute pain management. Demonstrates efficacy comparable to opioids for moderate to severe pain but with a different side effect profile.
Lab Monitoring
- Renal function (BUN, creatinine) particularly in patients at risk for renal impairment.
- Liver function tests (ALT, AST) periodically during prolonged treatment.
- Complete blood count (CBC) if used for more than 5 days or if signs of bleeding appear.
Doctor Notes
- Ketorolac injection should not be used for more than 5 days due to the risk of serious adverse effects.
- Consider lowest effective dose for shortest duration possible, especially in elderly or renally impaired patients.
Patient Guidelines
- Report any signs of stomach pain, black stools, or unusual bleeding/bruising immediately.
- Avoid concurrent use of alcohol or other NSAIDs without consulting a doctor.
- Do not exceed the prescribed dose or duration of treatment.
Missed Dose Advice
As this is an injection administered by a healthcare professional, a missed dose is unlikely. If administered at home and a dose is missed, contact your doctor for advice.
Driving Precautions
May cause dizziness or drowsiness. Patients should be advised to avoid driving or operating machinery until they know how this medication affects them.
Lifestyle Advice
- Maintain adequate hydration.
- Avoid activities requiring mental alertness if experiencing dizziness or drowsiness.
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