Temoket
Generic Name
Ketorolac Tromethamine
Manufacturer
A reputable Pharmaceutical Company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| temoket 30 mg injection | ৳ 55.00 | N/A |
Description
Overview of the medicine
Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) used for the short-term management of moderately severe acute pain that requires opioid-level analgesia.
Uses & Indications
Dosage
Adults
Initial single IM dose of 30 mg or 60 mg, or IV 30 mg. Subsequent doses of 15 mg or 30 mg IM/IV every 6 hours as needed. Maximum total daily dose is 120 mg, not to exceed 5 days. For continuous IV, 30 mg bolus, then 3.75 mg/hour.
Elderly
Lower doses recommended. For patients ≥65 years, renal impaired patients, or patients weighing <50 kg, the maximum total daily dose is 60 mg.
Renal_impairment
Significant dose reduction (e.g., 15 mg IM/IV every 6 hours); not recommended for severe renal impairment (creatinine clearance <30 mL/min).
How to Take
For intramuscular (IM) administration, inject slowly and deeply into a large muscle. For intravenous (IV) administration, inject over at least 15 seconds into a vein.
Mechanism of Action
Inhibits prostaglandin synthesis by blocking cyclooxygenase (COX-1 and COX-2) enzymes, leading to analgesic, anti-inflammatory, and antipyretic effects.
Pharmacokinetics
Onset
Analgesia usually begins within 1 hour after IM/IV dose.
Excretion
Mainly renal (approximately 90%, with 60% as unchanged drug), some fecal excretion.
Half life
Approximately 4-6 hours (dose-dependent, varies with age and renal function).
Absorption
Rapidly and completely absorbed after intramuscular (IM) administration. Peak plasma concentrations reached within 30-60 minutes.
Metabolism
Primarily hepatic, via hydroxylation and conjugation. Main metabolite is p-hydroxyketorolac.
Side Effects
Contraindications
- Active peptic ulcer, gastrointestinal bleeding, or perforation.
- Advanced renal impairment or risk of renal failure due to dehydration.
- History of asthma, urticaria, or other allergic-type reactions to aspirin or other NSAIDs.
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
- Coagulation disorders or patients at high risk of bleeding.
- Pregnancy, labor, delivery, or breastfeeding.
- Concomitant use with other NSAIDs, aspirin, probenecid, or pentoxifylline.
Drug Interactions
Lithium
Increased plasma lithium levels, potential for toxicity.
Probenecid
Reduced clearance of ketorolac, significantly increased plasma levels and half-life.
Methotrexate
Increased methotrexate toxicity.
Pentoxifylline
Increased risk of bleeding.
ACE inhibitors/ARBs
Increased risk of renal impairment, reduced antihypertensive effect.
Other NSAIDs/Aspirin
Increased risk of GI adverse effects.
Diuretics (e.g., furosemide, thiazides)
Reduced natriuretic and antihypertensive effect.
Anticoagulants (e.g., warfarin, heparin)
Increased risk of bleeding.
Storage
Store at controlled room temperature (20-25°C), excursions permitted to 15-30°C. Protect from light. Do not freeze.
Overdose
Symptoms of overdose may include abdominal pain, nausea, vomiting, lethargy. Rarely, gastrointestinal bleeding, acute renal failure, respiratory depression, or coma may occur. Management is symptomatic and supportive; there is no specific antidote. Gastric decontamination may be considered if recent oral ingestion.
Pregnancy & Lactation
Ketorolac is contraindicated during pregnancy, labor, delivery, and breastfeeding due to potential fetal harm (e.g., premature closure of ductus arteriosus) and excretion in human milk.
Side Effects
Contraindications
- Active peptic ulcer, gastrointestinal bleeding, or perforation.
- Advanced renal impairment or risk of renal failure due to dehydration.
- History of asthma, urticaria, or other allergic-type reactions to aspirin or other NSAIDs.
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
- Coagulation disorders or patients at high risk of bleeding.
- Pregnancy, labor, delivery, or breastfeeding.
- Concomitant use with other NSAIDs, aspirin, probenecid, or pentoxifylline.
Drug Interactions
Lithium
Increased plasma lithium levels, potential for toxicity.
Probenecid
Reduced clearance of ketorolac, significantly increased plasma levels and half-life.
Methotrexate
Increased methotrexate toxicity.
Pentoxifylline
Increased risk of bleeding.
ACE inhibitors/ARBs
Increased risk of renal impairment, reduced antihypertensive effect.
Other NSAIDs/Aspirin
Increased risk of GI adverse effects.
Diuretics (e.g., furosemide, thiazides)
Reduced natriuretic and antihypertensive effect.
Anticoagulants (e.g., warfarin, heparin)
Increased risk of bleeding.
Storage
Store at controlled room temperature (20-25°C), excursions permitted to 15-30°C. Protect from light. Do not freeze.
Overdose
Symptoms of overdose may include abdominal pain, nausea, vomiting, lethargy. Rarely, gastrointestinal bleeding, acute renal failure, respiratory depression, or coma may occur. Management is symptomatic and supportive; there is no specific antidote. Gastric decontamination may be considered if recent oral ingestion.
Pregnancy & Lactation
Ketorolac is contraindicated during pregnancy, labor, delivery, and breastfeeding due to potential fetal harm (e.g., premature closure of ductus arteriosus) and excretion in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, as indicated on the product packaging.
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved by regulatory authorities
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Ketorolac has undergone extensive clinical trials demonstrating its efficacy and safety for short-term acute pain management, with data supporting its use in various surgical and non-surgical settings.
Lab Monitoring
- Renal function (BUN, creatinine) before and during treatment.
- Liver function (ALT, AST) if signs of hepatic dysfunction appear.
- Hemoglobin/Hematocrit (due to potential GI bleeding, especially with prolonged use).
- Coagulation parameters (if high risk for bleeding or on concomitant anticoagulants).
Doctor Notes
- Careful patient selection is crucial, especially regarding gastrointestinal, renal, and cardiovascular risk factors.
- The shortest effective duration and lowest effective dose should always be used to minimize risks.
- Monitor patients for signs of adverse reactions, particularly gastrointestinal bleeding and renal dysfunction.
- Avoid concomitant use with other NSAIDs, aspirin, or drugs increasing bleeding risk.
Patient Guidelines
- Report any signs of gastrointestinal bleeding (e.g., black, tarry stools; vomiting blood) immediately.
- Report signs of allergic reaction (e.g., rash, difficulty breathing, swelling) promptly.
- Do not use this medicine for more than 5 days as directed by your doctor.
- Avoid concurrent use with other NSAIDs or aspirin unless specifically instructed by your physician.
Missed Dose Advice
Since Temoket Injection is typically administered by a healthcare professional for acute pain, a missed dose is unlikely in a controlled setting. If a scheduled dose is missed in an outpatient setting, contact your doctor for advice; do not double the dose.
Driving Precautions
Ketorolac may cause dizziness, drowsiness, or visual disturbances. Patients should be cautioned against driving or operating machinery if they experience these effects.
Lifestyle Advice
- Avoid alcohol consumption during treatment as it may increase the risk of gastrointestinal side effects.
- Avoid activities requiring mental alertness, such as driving or operating machinery, if you experience dizziness or drowsiness.
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