Temoket
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 |
|---|---|---|
| temoket 10 mg tablet | ৳ 11.00 | ৳ 110.00 |
Description
Overview of the medicine
Temoket 10 mg Tablet is used for the short-term management of moderate to severe acute pain. It belongs to a class of drugs called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs).
Uses & Indications
Dosage
Adults
Oral: 10 mg every 4-6 hours as needed, not exceeding 40 mg/day. Maximum duration of treatment should not exceed 5 days.
Elderly
A lower dose, e.g., 10 mg every 6-8 hours, not exceeding 30 mg/day, for a maximum of 5 days. Monitor closely for adverse effects.
Renal_impairment
Contraindicated in severe renal impairment. In mild to moderate impairment, use with caution at reduced doses and increased intervals, not exceeding 20 mg/day.
How to Take
Take the tablet orally, preferably with food or milk to minimize gastrointestinal upset. Do not crush or chew the tablet.
Mechanism of Action
Ketorolac Tromethamine works by inhibiting the synthesis of prostaglandins, which are chemicals in the body that cause pain, inflammation, and fever. It primarily inhibits cyclooxygenase (COX-1 and COX-2) enzymes.
Pharmacokinetics
Onset
Analgesic effect typically begins within 30-60 minutes.
Excretion
Mainly excreted by the kidneys (approximately 92% in urine, 6% in feces).
Half life
Approximately 4-6 hours.
Absorption
Rapid and complete absorption after oral administration. Peak plasma concentrations are achieved within 30-60 minutes.
Metabolism
Primarily metabolized in the liver via glucuronidation and hydroxylation.
Side Effects
Contraindications
- Hypersensitivity to Ketorolac, aspirin, or other NSAIDs
- Active peptic ulcer disease, gastrointestinal bleeding, or perforation
- Severe renal impairment or advanced renal disease
- History of cerebrovascular bleeding or bleeding diathesis
- Concomitant use with other NSAIDs, aspirin, anticoagulants (e.g., warfarin), or probenecid
- As a prophylactic analgesic before major surgery or during labor and delivery
- Pregnancy (especially third trimester) and breastfeeding
- Children under 16 years of age
Drug Interactions
SSRIs
Increased risk of gastrointestinal bleeding.
Lithium
May increase lithium plasma levels, leading to toxicity.
Methotrexate
May increase methotrexate toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration and bleeding.
ACE Inhibitors/ARBs
May reduce the antihypertensive effect and increase the risk of renal impairment.
Other NSAIDs or Aspirin
Increased risk of gastrointestinal adverse effects and bleeding.
Diuretics (e.g., Furosemide, Thiazides)
May reduce diuretic effect and increase risk of renal impairment.
Anticoagulants (e.g., Warfarin, Heparin)
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, nausea, vomiting, epigastric pain, lethargy, and gastrointestinal bleeding. Management involves supportive care, gastric lavage, and activated charcoal if ingested recently. Dialysis does not significantly remove ketorolac from the bloodstream.
Pregnancy & Lactation
Pregnancy Category C (first and second trimesters), D (third trimester). Ketorolac is contraindicated in the third trimester of pregnancy due to the risk of premature closure of the fetal ductus arteriosus. It is not recommended during breastfeeding as it is excreted in breast milk and may cause adverse effects in the infant.
Side Effects
Contraindications
- Hypersensitivity to Ketorolac, aspirin, or other NSAIDs
- Active peptic ulcer disease, gastrointestinal bleeding, or perforation
- Severe renal impairment or advanced renal disease
- History of cerebrovascular bleeding or bleeding diathesis
- Concomitant use with other NSAIDs, aspirin, anticoagulants (e.g., warfarin), or probenecid
- As a prophylactic analgesic before major surgery or during labor and delivery
- Pregnancy (especially third trimester) and breastfeeding
- Children under 16 years of age
Drug Interactions
SSRIs
Increased risk of gastrointestinal bleeding.
Lithium
May increase lithium plasma levels, leading to toxicity.
Methotrexate
May increase methotrexate toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration and bleeding.
ACE Inhibitors/ARBs
May reduce the antihypertensive effect and increase the risk of renal impairment.
Other NSAIDs or Aspirin
Increased risk of gastrointestinal adverse effects and bleeding.
Diuretics (e.g., Furosemide, Thiazides)
May reduce diuretic effect and increase risk of renal impairment.
Anticoagulants (e.g., Warfarin, Heparin)
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, nausea, vomiting, epigastric pain, lethargy, and gastrointestinal bleeding. Management involves supportive care, gastric lavage, and activated charcoal if ingested recently. Dialysis does not significantly remove ketorolac from the bloodstream.
Pregnancy & Lactation
Pregnancy Category C (first and second trimesters), D (third trimester). Ketorolac is contraindicated in the third trimester of pregnancy due to the risk of premature closure of the fetal ductus arteriosus. It is not recommended during breastfeeding as it is excreted in breast milk and may cause adverse effects in the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved (local regulatory bodies)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of Ketorolac for short-term management of acute pain, particularly in post-operative settings.
Lab Monitoring
- Renal function (serum creatinine, BUN) before initiation and periodically during treatment, especially in elderly or renally impaired patients.
- Liver function tests (ALT, AST) if used for longer durations or if liver dysfunction is suspected.
- Complete Blood Count (CBC) if used for prolonged periods (beyond 5 days), to monitor for anemia or other blood dyscrasias.
Doctor Notes
- Emphasize the strict adherence to the maximum 5-day treatment duration for oral Ketorolac due to significant risks.
- Caution in elderly patients and those with risk factors for GI or renal toxicity; use lowest effective dose and monitor closely.
- Contraindicated in patients with moderate to severe renal impairment, active GI bleeding, or those on anticoagulants.
- Advise patients to take with food to minimize GI discomfort.
Patient Guidelines
- Do not take this medicine for more than 5 days for pain relief.
- Take with food or milk to reduce stomach upset.
- Report any signs of stomach bleeding (e.g., black, tarry stools, vomiting blood) or allergic reactions (e.g., rash, swelling of face/throat) immediately to your doctor.
- Avoid taking other NSAIDs or aspirin while on this medication without consulting your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Temoket 10 mg Tablet may cause dizziness, drowsiness, or visual disturbances. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Avoid alcohol consumption during treatment to reduce the risk of gastrointestinal side effects.
- Stay hydrated by drinking plenty of fluids.
- Consult your doctor before engaging in strenuous activities if you experience dizziness or drowsiness.
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