Tolec
Generic Name
Ketorolac Tromethamine
Manufacturer
Acme Laboratories Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tolec 30 mg injection | ৳ 55.17 | N/A |
Description
Overview of the medicine
Tolec 30 mg Injection contains Ketorolac Tromethamine, a non-steroidal anti-inflammatory drug (NSAID) used for the short-term management of moderate to severe acute pain, typically in a hospital setting.
Uses & Indications
Dosage
Adults
Adults under 65 years: Initial dose 30 mg IM or IV once, then 15-30 mg IM or IV every 6 hours as needed. Maximum 120 mg/day. Treatment duration should not exceed 5 days.
Elderly
Elderly patients (65 years and older) or patients with renal impairment: Initial dose 15 mg IM or IV once, then 15 mg IM or IV every 6 hours as needed. Maximum 60 mg/day.
Renal_impairment
Reduced dosage required for mild-to-moderate renal impairment; contraindicated in severe renal impairment.
How to Take
Administer intramuscularly (IM) deeply into the muscle or intravenously (IV) as a slow bolus over at least 15 seconds.
Mechanism of Action
Ketorolac inhibits prostaglandin synthesis by blocking cyclooxygenase (COX-1 and COX-2) enzymes, thereby reducing pain and inflammation.
Pharmacokinetics
Onset
Within 10 minutes (IV), 30-60 minutes (IM).
Excretion
Mainly renal (approximately 90%).
Half life
Approximately 4-6 hours.
Absorption
Rapid and complete absorption after intramuscular (IM) administration.
Metabolism
Primarily hepatic via glucuronidation.
Side Effects
Contraindications
- Hypersensitivity to ketorolac or other NSAIDs
- Active peptic ulcer or gastrointestinal bleeding
- History of GI bleeding or perforation related to previous NSAID therapy
- Severe renal impairment
- Cerebrovascular bleeding or bleeding disorders
- Concurrent use with other NSAIDs, aspirin, or anticoagulants
- Before major surgery, during labor and delivery
- Patients undergoing coronary artery bypass graft (CABG) surgery
Drug Interactions
Lithium
Increases plasma lithium levels.
Methotrexate
Increases methotrexate toxicity.
ACE Inhibitors, Diuretics
May reduce antihypertensive effect and increase risk of renal impairment.
Corticosteroids, other NSAIDs
Increased risk of GI adverse effects.
Warfarin, Heparin, Antiplatelet agents
Increased risk of bleeding.
Storage
Store below 30°C. Protect from light. Do not freeze.
Overdose
Symptoms of overdose may include abdominal pain, nausea, vomiting, lethargy, and drowsiness. Management is supportive and symptomatic; there is no specific antidote.
Pregnancy & Lactation
Avoid in the third trimester of pregnancy due to risk of premature closure of the fetal ductus arteriosus. Not recommended during lactation as it is excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to ketorolac or other NSAIDs
- Active peptic ulcer or gastrointestinal bleeding
- History of GI bleeding or perforation related to previous NSAID therapy
- Severe renal impairment
- Cerebrovascular bleeding or bleeding disorders
- Concurrent use with other NSAIDs, aspirin, or anticoagulants
- Before major surgery, during labor and delivery
- Patients undergoing coronary artery bypass graft (CABG) surgery
Drug Interactions
Lithium
Increases plasma lithium levels.
Methotrexate
Increases methotrexate toxicity.
ACE Inhibitors, Diuretics
May reduce antihypertensive effect and increase risk of renal impairment.
Corticosteroids, other NSAIDs
Increased risk of GI adverse effects.
Warfarin, Heparin, Antiplatelet agents
Increased risk of bleeding.
Storage
Store below 30°C. Protect from light. Do not freeze.
Overdose
Symptoms of overdose may include abdominal pain, nausea, vomiting, lethargy, and drowsiness. Management is supportive and symptomatic; there is no specific antidote.
Pregnancy & Lactation
Avoid in the third trimester of pregnancy due to risk of premature closure of the fetal ductus arteriosus. Not recommended during lactation as it is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from the date of manufacture, depending on storage conditions.
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory authorities (e.g., DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety profile of Ketorolac for acute pain management.
Lab Monitoring
- Renal function (creatinine, BUN)
- Liver function (ALT, AST)
- Complete blood count (CBC)
- Stool for occult blood (for long-term use)
Doctor Notes
- Use the lowest effective dose for the shortest possible duration.
- Monitor patients for signs of GI bleeding, renal impairment, and cardiovascular adverse events.
- Not for chronic pain management.
Patient Guidelines
- Do not exceed the prescribed dose or duration of treatment.
- Report any severe stomach pain, black stools, or unusual bleeding/bruising to your doctor immediately.
- Ensure adequate hydration during treatment.
- Avoid taking other NSAIDs or aspirin concurrently unless advised by a doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Tolec injection may cause dizziness, drowsiness, or visual disturbances. Patients should be cautious when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Avoid alcohol consumption, as it may increase the risk of stomach bleeding.
- Discuss all current medications, including over-the-counter drugs and herbal supplements, with your healthcare provider.
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