Torax
Generic Name
Ketorolac Tromethamine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| torax 30 mg injection | ৳ 60.00 | N/A |
Description
Overview of the medicine
Torax 30 mg Injection contains Ketorolac Tromethamine, a non-steroidal anti-inflammatory drug (NSAID) used for the short-term management of moderately severe acute pain that requires opioid-level analgesia, usually in a postoperative setting.
Uses & Indications
Dosage
Adults
Single IM dose of 30 mg or IV dose of 15-30 mg. Max 120 mg/day for IM/IV. Treatment duration should not exceed 5 days.
Elderly
Lower doses (e.g., 15 mg IM/IV every 6 hours) are recommended, maximum 60 mg/day. Close monitoring for adverse effects.
Renal_impairment
Significantly reduced dosage (e.g., 15 mg IM/IV every 6 hours), maximum 60 mg/day, depending on the degree of impairment. Not recommended in severe renal impairment.
How to Take
Administer intramuscularly (IM) or intravenously (IV). For IV administration, it should be given as a bolus over at least 15 seconds. Do not administer epidurally or intrathecally.
Mechanism of Action
Ketorolac is a non-selective inhibitor of cyclooxygenase (COX-1 and COX-2) enzymes, which are responsible for the synthesis of prostaglandins from arachidonic acid. By inhibiting prostaglandin synthesis, it reduces pain, inflammation, and fever.
Pharmacokinetics
Onset
30-60 minutes
Excretion
Mainly renal (approximately 91% as unchanged drug and metabolites), with a small amount excreted in feces (approximately 6%).
Half life
Approximately 5-6 hours in healthy adults.
Absorption
Rapid and complete absorption after intramuscular administration. Peak plasma concentrations are reached in approximately 30-60 minutes.
Metabolism
Primarily hepatic, mainly by glucuronidation. Some hydroxylation also occurs.
Side Effects
Contraindications
- History of peptic ulcer disease or GI bleeding
- Severe renal impairment
- Advanced renal disease or patients at risk of renal failure due to volume depletion
- Coagulopathy or patients receiving anticoagulants
- Cerebrovascular hemorrhage (suspected or confirmed)
- Hypersensitivity to Ketorolac or other NSAIDs
- As prophylactic analgesia before major surgery or intraoperatively
- During labor and delivery
- Children under 16 years of age
- Concomitant use with other NSAIDs, aspirin, or probenecid
Drug Interactions
Lithium
Increased plasma lithium levels, leading to lithium toxicity.
Probenecid
Reduced clearance of Ketorolac, leading to increased plasma levels and half-life.
SSRIs/SNRIs
Increased risk of GI bleeding.
Methotrexate
Increased methotrexate toxicity.
Other NSAIDs, Aspirin
Increased risk of gastrointestinal adverse effects and bleeding.
Diuretics (e.g., Furosemide, Thiazides)
Reduced diuretic and antihypertensive effects; increased risk of renal impairment.
Warfarin, Heparin, other Anticoagulants
Increased risk of bleeding.
ACE inhibitors, Angiotensin II receptor blockers (ARBs)
Reduced antihypertensive effect; increased risk of renal impairment.
Storage
Store below 30°C. Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms may include epigastric pain, nausea, vomiting, lethargy, drowsiness. Rarely, GI bleeding, hypertension, acute renal failure, respiratory depression, and coma may occur. Management is primarily supportive and symptomatic. Gastric decontamination may be considered within 4 hours of ingestion for oral formulations, but for injection, supportive care is crucial.
Pregnancy & Lactation
Pregnancy Category C (first and second trimesters), Category D (third trimester). Use during pregnancy should be avoided, especially in the third trimester due to potential premature closure of the fetal ductus arteriosus. Not recommended during breastfeeding as Ketorolac is excreted in breast milk.
Side Effects
Contraindications
- History of peptic ulcer disease or GI bleeding
- Severe renal impairment
- Advanced renal disease or patients at risk of renal failure due to volume depletion
- Coagulopathy or patients receiving anticoagulants
- Cerebrovascular hemorrhage (suspected or confirmed)
- Hypersensitivity to Ketorolac or other NSAIDs
- As prophylactic analgesia before major surgery or intraoperatively
- During labor and delivery
- Children under 16 years of age
- Concomitant use with other NSAIDs, aspirin, or probenecid
Drug Interactions
Lithium
Increased plasma lithium levels, leading to lithium toxicity.
Probenecid
Reduced clearance of Ketorolac, leading to increased plasma levels and half-life.
SSRIs/SNRIs
Increased risk of GI bleeding.
Methotrexate
Increased methotrexate toxicity.
Other NSAIDs, Aspirin
Increased risk of gastrointestinal adverse effects and bleeding.
Diuretics (e.g., Furosemide, Thiazides)
Reduced diuretic and antihypertensive effects; increased risk of renal impairment.
Warfarin, Heparin, other Anticoagulants
Increased risk of bleeding.
ACE inhibitors, Angiotensin II receptor blockers (ARBs)
Reduced antihypertensive effect; increased risk of renal impairment.
Storage
Store below 30°C. Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms may include epigastric pain, nausea, vomiting, lethargy, drowsiness. Rarely, GI bleeding, hypertension, acute renal failure, respiratory depression, and coma may occur. Management is primarily supportive and symptomatic. Gastric decontamination may be considered within 4 hours of ingestion for oral formulations, but for injection, supportive care is crucial.
Pregnancy & Lactation
Pregnancy Category C (first and second trimesters), Category D (third trimester). Use during pregnancy should be avoided, especially in the third trimester due to potential premature closure of the fetal ductus arteriosus. Not recommended during breastfeeding as Ketorolac is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date when stored correctly.
Availability
Pharmacies, Hospitals
Approval Status
Approved by DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensively studied in numerous clinical trials demonstrating its efficacy in acute pain management, particularly postoperative pain, with comparisons to opioids and other NSAIDs. Ongoing studies focus on new indications and safety profiles.
Lab Monitoring
- Renal function (BUN, creatinine)
- Liver function tests (ALT, AST)
- Complete blood count (CBC) for potential bleeding
- Blood pressure monitoring
Doctor Notes
- Stress strict adherence to the 5-day maximum treatment duration.
- Evaluate renal function before and during treatment, especially in at-risk patients.
- Counsel patients on GI and cardiovascular risks.
- Consider lower doses for elderly and renally impaired patients.
Patient Guidelines
- Inform your doctor about all other medications you are taking.
- Report any signs of stomach bleeding (black stools, vomiting blood) immediately.
- Avoid alcohol consumption during treatment.
- Do not exceed the prescribed dose or duration of treatment.
- This medicine is for short-term use only.
Missed Dose Advice
If a dose is missed, administer it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness, drowsiness, or visual disturbances. Patients should be cautioned against driving or operating machinery if they experience these effects.
Lifestyle Advice
- Maintain adequate hydration.
- Avoid activities that may increase the risk of injury.
- Follow up with your doctor as advised.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
Other Medicines in Torax Brand
Other medicines available under the same brand name
