How long does it take for ketorol tablets to start working?

How do Ketorol tablets work?

Ketorol not only helps relieve pain, but also relieves inflammation and swelling of soft tissues. This drug belongs to the category of anti-inflammatory non-steroidal drugs and has the following effects on the body:

• relieves inflammation;
• relieves acute pain;
• has an antipyretic effect.

Ketorol's pain relief is quite strong and in this respect resembles the effect of morphine, but the use of these tablets is more effective and safe. The key active ingredient is ketorolac tromethamine, which has a therapeutic effect even in small doses. This drug helps against different types of pain , differing in type of manifestation and pathogenesis.

Taking Ketorol tablets has an effect due to the complete absorption of the active components in the gastrointestinal tract. An hour after taking the drug, the maximum concentration occurs. If a person’s diet mainly contains fatty foods, then the absorption process slows down. Disintegration and formation of active metabolites occur after approximately 3-4 hours.

Depending on the dosage of the drug, after about half an hour the antipyretic and analgesic effect appears. Ketorol is taken to relieve symptomatic pain and to fully treat a number of diseases in which swelling and fever are observed.

Do topical medications affect the heart?

All medications can be divided into general (systemic) and local drugs. This division is fundamentally important, since the same medicine in different situations has different side effects. Including the heart.

Generally acting drugs, after entering the body, reach the bloodstream and spread to all organs and tissues. The purpose of such drugs is to treat a specific disease, however, given that they are in the blood and penetrate everywhere, it is possible that they will not always have a positive effect.

For example, during the treatment of threatened abortion with the drug Ginipral, pronounced palpitations are very often observed, sometimes blood pressure rises, pain in the heart area is noted, and rarely, but the development of arrhythmia is possible. This is due to the fact that there are similar receptors in the uterus, heart and blood vessels and the drug acts on all of them indiscriminately. And there are many such examples.

Topical medications do not penetrate the bloodstream, but act locally. From the point of view of the development of side effects, they are safer, since they have their effect only where it is needed. They exist most often in the form of ointments, gels, sprays for application to the skin, in the form of inhalations for the treatment of diseases of the upper respiratory tract and bronchi, etc.

For example, steroid hormones that are used for basic therapy of bronchial asthma in the form of inhalations (beclomethasone, budesonide, etc.) act exclusively on the cells of the surface of the bronchi. In this case, the scary word “steroids” turns out to be completely safe in terms of side effects.

However, not every disease can be cured with topical medications. For example, hypertension and rheumatoid arthritis are treated exclusively with tablets; no ointments or sprays will help. Which treatment method to choose is decided solely by the attending physician.

The latest findings from drug safety researchers are warning people that large doses of the drug Loperamide, which is used to treat diarrhea, may be dangerous for the heart. We are talking about exceeding the maximum daily dose several times. The consequences of such a thoughtless intake can be quite sad: the development of serious arrhythmias leading to loss of consciousness and even cardiac arrest.

The reason why these studies were carried out was that there were people who use loperamide in order to obtain a kind of drug intoxication. However, in order for it to develop, a person must take a very large dose of this seemingly harmless medicine.

Experts urge that in case of diarrhea lasting more than 2 days, you should definitely consult a doctor for a full examination. Perhaps antidiarrheal drugs alone are not enough and serious therapy is necessary.

Self-medication can lead to serious heart problems. A doctor is the best assistant for a patient, and he will always be able to choose the most effective and safe drug.

Alexey Vladimirovich Klevzhits, cardiologist, functional diagnostician at the multidisciplinary medical center NouvelClinique, member of the Russian Society of Cardiology.

We invite you to familiarize yourself with Ketorol - instructions, use, contraindications

There are many drugs that are used to treat various diseases and can have a negative effect on the cardiovascular system. They are prescribed strictly according to indications after visiting a doctor. The most common of them:

1. Non-steroidal anti-inflammatory drugs (diclofenac, ketorol, ketorolac, aspirin, nise, meloxicam, etc.). Typically prescribed for rheumatoid arthritis, osteoarthritis, gout, headaches and migraines, as well as fever. The only side effect of these drugs on the cardiovascular system is an increase in blood pressure.
2. Bronchodilators (aminophylline, theophylline, ephedrine, berodual, etc.) are used for bronchial asthma, chronic obstructive bronchitis, pulmonary hypertension, cor pulmonale, emphysema). Side effects - increased heart rate, arrhythmias, pain in the heart, decreased blood pressure.
3. Oral contraceptives (cyclo-progynova, microgynon, Marvelon, Silest, Vidora, trigestrel). Used for contraceptive purposes. The main side effects from the heart are thrombosis and thromboembolism, increased heart rate, increased blood pressure, increased blood cholesterol, and the risk of a heart attack.
4. Centrally acting muscle relaxants (mydocalm, baclofen). They are used for muscle spasms, after traumatological and orthopedic operations, etc.) Side effects from the heart are a drop in blood pressure.
5. Drugs for the treatment of erectile dysfunction (Viagra, Cialis, Levitra). Side effects from the cardiovascular system - rapid heartbeat, decreased blood pressure, fainting, nosebleeds.

These medications are taken strictly as prescribed by the doctor. Check with your doctor before you start taking these medications.

Ketorol tablets and their composition

Ketorol tablets are coated with a soluble green coating. They have a biconvex shape, which improves the swallowing process. The tablets are equipped with a special S-shaped embossing. The drug is packaged in 10 pieces in a plastic blister with a metal coating. The number of blisters in a package may vary, and the cost of the drug depends on this.

The composition of Ketorol is as follows:

• ketorolac tromethamine;
• corn starch;
• lactose;
• propylene glycol;
• microcrystalline cellulose;
• titanium dioxide;
• colloidal sodium dioxide;
• diamond natural dye;
• hypromellose;
• sodium carboxymethyl starch.

The manufacturer may change the composition of the tablets, but the active ingredient will be the same and will be present in an amount of 10 mg per tablet .

Compound

Ketorol belongs to the group of nonsteroidal anti-inflammatory drugs (NSAIDs). It exhibits moderate anti-inflammatory, thermoregulatory and pronounced analgesic effects. The composition of the drug includes:

• ketorolac tromethamine;
• excipients that increase biological activity and facilitate digestibility: chloride (NaCl) and sodium hydroxide (NaOH), EDTA, methyl carbinol, propylene glycol, prepared water.

The solution (1 ml) is homogeneous, free of foreign inclusions, transparent, placed in a dark glass ampoule, contains 30 mg/ml of the active substance. The liquid is colorless or straw-colored. The drug is intended for injection: intramuscular and intravenous. It is also available in other pharmaceutical forms - tablets, gel.

Ketorol is a non-selective inhibitor of dopamine receptors and an antagonist of COX-1 and COX-2. The drug inhibits the synthesis of prostaglandins, which prevents inflammation, reducing pain sensitivity, and normalizing temperature.

Ketorol (injections) is a complex of [-]S and [+]R stereoisomers. They are present in equal proportions, but only the [-]S isoform has a pronounced analgesic ability.

Ketorol dosage rules

Ketorol tablets are used when the pain is severe, but not life-threatening. To relieve more severe pain, injections are used; they are absorbed faster and reduce the pain of a particular area.

The dosage of the tablet depends on factors such as:

• age;
• intensity of pain;
• features of the course of diseases.

For pain relief, the optimal dosage is 10 mg. For severe pain, it can be increased to 2 tablets. If Ketorol is prescribed as a course, then the dosage and duration of treatment are determined individually.

However, the permissible daily dosage of Ketorol is a maximum of 4 tablets . If it is exceeded, side effects may appear that negatively affect the course of the disease and complicate it.

Ketorol for acute back pain

Effective treatment of this group of patients implies timely relief of pain syndrome (PS), elimination of obstacles to carrying out the full scope of rehabilitation measures, and adequate expansion of the motor regime. It has been established that the earliest possible expansion of the motor mode (walking on a flat surface, performing familiar daily activities both at home and outside) is an important factor associated with early relief of pain and a reduction in disability. There is evidence that long-term bed rest (immobilization for more than 7 days), excessive restrictive behavior (both intuitively chosen by the patient himself and recommended by the doctor) are most closely associated with a high risk of increasing the duration of exacerbation, transformation of acute pain into chronic, high probability of developing depressive disorders [3]. Based on these considerations, it seems necessary to orient the patient toward the earliest possible inclusion in the program of restorative and rehabilitation measures, to recommend the patient active behavior as part of the course of restorative treatment, to form positive motivation that ensures the mood to achieve convalescence and compensation for the existing neurological and orthopedic defect. The patient himself should strive for the earliest possible return to the usual level of daily physical activity as the syndrome is relieved. Along the way, it should be noted that factors that negatively affect the effectiveness of therapeutic measures and the timing of rehabilitation therapy are the patient’s incomplete understanding of the cause and essence of his disease, reluctance to take an active position in achieving recovery, the expectation of a significant therapeutic effect from passive therapeutic measures (massage, physiotherapy and etc.). An important condition that determines the possibility of carrying out rehabilitation measures is the early and most complete elimination of BS. There is an obvious connection between the effectiveness of pain therapy and the duration of restoration of adequate motor activity. To relieve pain syndrome (PS), the most widely used drugs are from the group of nonsteroidal anti-inflammatory drugs (NSAIDs). One of the effective NSAIDs used incl. for the treatment of patients with dorsalgia, is Ketorol (ketorolac) - a derivative of arylacetic acid. In clinical practice, it is used in the form of tromethamine salt, which ensures high solubility of the drug in water. In accordance with the results of modern experimental and clinical studies, ketorolac is an effective inhibitor of cyclooxygenase types 1 and 2, which regulates the synthesis of prostaglandins, prostacyclin and thromboxane A2 from arachidonic acid. Ketorolac is a racemic mixture of S(-) and R(+) enantiomers, with the analgesic effect due to the S-form. Without interacting with opioid receptors, ketorolac does not have a cardiodepressive effect, does not depress respiration, and does not cause paresis of intestinal smooth muscles. Of undoubted interest are the recently presented results of experimental studies indicating that ketorolac has the ability to reduce the activation activity of spinal cord glial cells that provide pain sensitivity, in particular by inhibiting the expression of protease-activated receptor-1 [4]. As the authors of the study established, it was precisely due to these properties of the drug that its use significantly reduced the severity of allodynia if ketorolac was administered one day after the injury. It should be noted that the ability of ketorolac to eliminate allodynia caused in the primary headache model was established in another study [5]. The drug is characterized by high bioavailability (80–100%) and quickly enters the vascular bed both after oral and parenteral administration, which ensures rapid onset of analgesia. In practical terms, it should be borne in mind that food rich in fat increases the time to reach the maximum concentration of the drug in the blood by 1 hour. It has been established that after oral administration in a dose of 10 mg of the drug, the analgesic effect develops within 10–60 minutes, and after intramuscular administration in dose of 30 mg – after 15–75 minutes. In clinical settings, it has been demonstrated that the duration of action of ketorolac reaches 10 hours. Up to 95% of the drug entering the body binds to plasma proteins, which ensures the stability of the concentration of ketorolac in the blood. Ketorolac is metabolized primarily in the liver to form conjugated and hydroxylated forms, which are excreted by the kidneys. Given that a significant portion of the drug is excreted in the urine, impaired renal function is associated with the risk of developing toxic effects. The half-life of ketorolac in elderly patients is slightly longer than in young patients (4.7–8.6 and 3.8–6.3 hours, respectively). As noted above, ketorolac is well tolerated and has a low incidence of side effects (about 3%). The most common of these are dyspeptic disorders. Limiting the duration of treatment to achieve a positive effect can be a reliable way to increase the safety of therapy [6]. Currently, ketorolac is widely used in a number of countries to relieve acute BS caused by various pathological conditions, in particular to eliminate postoperative pain. A number of clinical studies have established the high analgesic effectiveness of the drug. The pronounced analgesic effect of ketorolac has attracted the attention of anesthesiologists and specialists faced with the need to relieve acute pain in somatic diseases and after surgical interventions. Thus, in one of the open pilot studies [7], intramuscular administration of ketorolac to 22 patients with severe postoperative PS provided an acceptable level of pain relief, and in 13 cases complete relief of pain was achieved. In 95% of patients, a decrease in pain intensity was observed during the first 60 minutes. after administration of the drug and increased over 2–4 hours, leading to complete elimination of pain in 50% of patients after 3.7 hours. The authors concluded that during the first hour after using ketorolac, additional administration of analgesic drugs is not advisable, given the high probability of delayed onset analgesic effect. An important property of ketorolac, in addition to pain relief, is its anti-inflammatory effect. It turned out that ketorolac administered into a postoperative wound in relatively small doses has an effect comparable to that after systemic use of NSAIDs, although the number of side effects turned out to be incomparably smaller [8]. This local use of the drug ensured a significant reduction in the need for patients to take opioid analgesics. According to the authors of the study, the effectiveness of the drug was due to the local anti-inflammatory effect, as evidenced by a decrease in the content of proinflammatory cytokines in the wound exudate. Similar data were obtained from another in vitro study. It turned out that ketorolac, introduced into cell culture, caused inhibition of the production of a number of proinflammatory cytokines and cell adhesion molecules, despite the fact that the effect was less pronounced than that of corticosteroids, it was significantly superior to that of placebo [9]. According to the authors, ketorolac has the ability to inhibit the cellular component of inflammation, which can find its practical application in the clinic. Somewhat later, a whole series of randomized, usually placebo-controlled, studies were conducted to evaluate the effectiveness of ketorolac in relieving acute BS caused by various pathological conditions. The objective of these works was to compare the effectiveness of ketorolac and representatives of other groups of analgesic drugs, in particular opioids and NSAIDs. In patients with BS caused by extensive surgery, intravenous administration of 30 mg of ketorolac in its analgesic activity was comparable to the administration of 4 mg of morphine [10]. Similarly, ketorolac was found to have comparable analgesic effects to another opioid derivative, meperidine (50 mg), when used in patients with acute hepatic colic, and the need for repeat analgesia was less likely to occur after ketorolac use [11]. The results of this work were confirmed somewhat later in a similar double-blind randomized study that included 324 patients with hepatic colic [12]. It turned out that 2 hours after the administration of ketorolac, the weakening of BS on the visual analogue scale (VAS) was 6.2±3.6 cm, and after the administration of meperidine – 6.7±3.6 cm (the differences were not significant; p=0 ,25). The authors noted better tolerability of ketorolac, as evidenced by a smaller number of patients who reported nausea, vomiting, and a feeling of general weakness. Another multicenter, double-blind study, including 125 patients undergoing arthroscopic autoplasty of the anterior cruciate ligament of the knee joint, compared the effectiveness of ketorolac (20 mg orally once) and a combination of 10 mg hydrocodone and 1000 mg paracetamol [13]. The effectiveness of ketorolac 1, 2 and 3 hours after administration was significantly higher, which allowed the authors to recommend the drug to eliminate BS in the postoperative period. Considering the analgesic effect and tolerability of ketorolac in comparison with opioids, it should be noted that there is experience in using the drug in pediatric practice: in children from 6 to 18 years old who have undergone orthopedic or arthrological surgery on large bones [14]. The results of an open study showed that the use of ketorolac (1.0 mg/kg parenterally as a loading dose, subsequently 0.5 mg/kg every 6 hours throughout the day) eliminates pain and significantly reduces the need for additional painkillers. Of interest are the results of a comparative study of the effectiveness of subacromial administration of triamcinolone or ketorolac for the purpose of relieving local BS [15]. Ketorolac has demonstrated its undoubted advantage as an analgesic agent with better tolerability. In a randomized, double-blind study that included 102 children, a single dose of ketorolac was not inferior to morphine in its analgesic effect [16]. It should be noted that in Russia the drug is approved for medical use in patients at least 16 years of age. Almost all researchers who studied the analgesic effectiveness of ketorolac noted its good tolerability. The undoubted advantage of ketorolac compared to narcotic painkillers is the absence of an inhibitory effect on respiratory function and the cardiovascular system, as well as the absence of sedation. It is important to note that there is no risk of addiction. It is also necessary to mention the absence of gastrotoxicity during short courses of treatment with ketorolac in order to eliminate acute BS. Considering the effectiveness of ketorolac in relieving postoperative pain, attempts have been made to use it in patients with acute pain caused by degenerative lesions of the articular-ligamentous apparatus. A randomized, double-blind study compared the effectiveness of intramuscular meperidine (1 mg/kg) and ketorolac (60 mg) for the relief of acute musculoskeletal pain in the low back in 155 patients over the age of 18 years [17]. The analgesic effect of the drugs according to VAS was comparable: a 30% decrease in pain intensity was recorded in 63% of patients receiving ketorolac and 67% of patients in the meperidine group; 35% of patients who received ketorolac and 37% who received meperidine required additional painkillers. The authors note that, with a comparable analgesic effect, treatment tolerability was significantly better in patients receiving ketorolac; they experienced significantly less unwanted side effects (nausea, repeated vomiting, drowsiness). A large-scale study was conducted in Moscow to study the effectiveness of ketorolac in patients with acute BS caused by inflammatory diseases of the musculoskeletal system, degenerative diseases of the spine (arthralgia, lumbago, ischalgia) and some other pathological conditions [18]. The study was conducted in the setting of prehospital medical care in an outpatient setting. A total of 1011 patients (mean age 54.1±0.46 years) who received ketorolac (30 mg intramuscularly) or other analgesic drugs, in particular metamizole sodium (2 ml of 50% solution intramuscularly) took part in the study. According to the results of assessing the dynamics of pain using VAS, the analgesic effect of ketorolac is 1.3 times greater than that of metamizole sodium. It is significant that the need to repeatedly seek medical help (call an ambulance team) for musculoskeletal pain was 3 times higher in patients who received metamizole (18% versus 6.2%). The onset of the analgesic effect after the administration of ketorolac was observed after an average of 12.4±0.33 minutes, whereas after the use of metamizole - after 26.9±0.47 minutes. (the difference was significant), and the severity and speed of onset of the effect did not significantly depend on the age of the patients. The data obtained allowed the authors to conclude that the use of ketorolac in the prehospital stage of treatment of acute BS of various etiologies is effective and clinically justified in various pathological conditions, in particular in acute musculoskeletal pain. It should be noted that, according to the results of the cited study, the use of ketorolac has certain pharmacoeconomic advantages: the value of such a parameter as the cost per unit of effectiveness turned out to be 3 times less than with the use of metamizole (the differences were significant), and significantly lower than with use of other NSAIDs. Almost simultaneously, an open, uncontrolled clinical trial was conducted, the purpose of which was to evaluate the effectiveness and safety of the use of parenteral and oral forms of ketorolac (Ketorol) in relieving moderate and severe back pain (at least 940 mm on VAS) [18]. The study included 30 patients aged 30–65 years (average age: 49.4 years, 17 men) with degenerative lesions of the lumbar spine. Diagnoses were verified based on the results of clinical and radiological studies. The duration of treatment for patients did not exceed 5 days. At the beginning of therapy, ketorolac was prescribed as intramuscular injections of 60 mg/day. (30 mg 2 times/day) for 2 days, and then in tablet form 20 mg/day. During the study period, the use of other NSAIDs was excluded. During the study, it was found that as a result of a 5-day course of using ketorolac, the intensity of BS according to VAS significantly decreased, and after parenteral administration of the first dose of the drug it decreased from 65.4 to 22.1 mm (p < 0.05). At the same time, the volume of active movements in the lumbar spine increased, which was reflected in the results of the Thomaier tests (increase in the range of movements by 33% from the initial indicators) and Schober (increase by 25%). Based on the data obtained, the authors concluded that ketorolac is highly effective and well tolerated. It seems important that when assessing the safety of the drug, only 16% of patients had side effects (gastralgia, feeling of fullness in the stomach, headache accompanied by a rise in blood pressure). These side effects were not severe and did not require discontinuation of the drug or change in its dosage regimen. Over the past years, significant experience has been accumulated in the use of ketorolac not only in patients with musculoskeletal pain syndromes, but also in other pathological conditions in neurology associated with intense pain. Of undoubted interest is the possibility of using the drug to relieve an acute attack of migraine. The results of meta -analysis of 8 randomized clinical studies (321 patients are included, of which 141 received ketorol parenterally), selected from 32 dedicated to the possibility of its use in migraine attack, showed that the drug is able to effectively stop the hemicacular attack [20]. It turned out that, by the ability to eliminate the attack of Ketorolak pain, he exceeded the constituent, introduced by orally, while its use was not associated with the risk of dependence, which could be observed when using some opioids, in particular meteridine. Thus, the results of numerous studies indicate that ketorolac (ketorol) is an effective and safe drug for the treatment of acute pain in the lower back. The use of Ketorolak (ketorol) in such patients in its effectiveness not only surpasses many NSAIDs, but is not inferior to weak opioids. Subject to the reception regimen, the drug is well tolerated by patients and does not cause serious side effects. Literature 1. Carey T., Evans A., Hadler N. et al. Acute Severe Low Back Pain. APPULATION-BASED Study of Prevalence and Care-seeking // Spine. 1996. Vol. 21. P. 339–344. 2. Luo X., Pietrobon R., Sun S. et al. Estimates and Patterns of Direct Health Care Expenditures Among Individuals with Back Pain in the United States // Spine. 2004. Vol. 29. P. 79–86. 3. Bair M., Robinson R., Katon W. et al. Depression and Pain Comorbidity: A Literature Review // Arch. Intern. Med. 2003. Vol. 163. P. 2433–2445. 4. Dong L., Smith J., Winkelstein B. Ketorolac Reduces Spinal Astrocytic Activation and Par1 Express Associated with AttenUtion of Pain Following Following Joint Injury // J. NeUROTRAMA. 2012. 5. Oshinsky M., Sangvi M., Maxwell C. et al. Spontaneous Trigeminal Allodynia in Rats: A Model of Primary Headache // Headache. 2012. Vol. 52 (9). P. 1336–1349. 6. BJarnason I. GastroinTestinal Safety of Nsaids and Over-the-Counter Anaalgesics // Int. J. Clin. Pract. Suppl. 2013. Vol. 178. P. 37–42. 7. Perez-Urizar J., Granados-Soto V., Castaneda-Hernandez G. et al. Anaalgesic Efficacy and Bioavailability of Ketorolac in Postoperation Pain: A Probability Analysis // Arch. Med. Res. 2000. Vol. 31 (2). P. 191–196. 8. Carvalho B., Lemmens H., Ting V., Angst M. Postoperation Subcutaneous Instillation of Low-Dose Ketorolac But Hydromorphone Reduces Wound Concentrations of Intereleum 6 and InterleUKIN-10 and IMPROVES ANALGESI Following Cesarean Delivery // J. Pain. 2013. Vol. 1. P. 48–56. 9. Mazzocca A., McCarthy M., Intravia J. et al. An in vitro evaluation of the anti-inflamMatory Effects of Platelet-Rich Plasma, Ketorolac, and Methylprednisolone // Arthroscopy. 2013. PII: S0749–8063 (12) 01896–8. DOI: 10.1016/J.Arthro 2012.12.005. 10. Brown C., Moodie J., Wild V. et al. Comparison of Intravenous Ketorolac Tromethamine and Morphine Sulfate in the Treatment of Postoperation Pain // PharmacoPyrapy. 1990. Vol.10 (6 (PT 2)). 116S --121S. 11. Dula D., Anderson R., Wood G. A Prospective Study Comparing Im Ketorolac with Im Meperidine in the Treatment of Acute Biliary Colic // J. Emerg. Med. 2001. Vol. 20 (2). P. 121–124. 12. Henderson S., Swadron S., Newton E. Comparison of Intravenous Ketorolac and Meperidine in the Treatment of Biliary Colic // J. Emerg. Med. 2002. Vol. 23 (3). P. 237–241. 13. Barber F., Gladu D. Comparison of Oral Ketorolac and Hydrocodone for Pain Relief After Anterior Cruciate Reconstruction // Arthroscopy. 1998. Vol. 14 (6). P. 605–612. 14. EBERSON C., Pacicca D., Ehrlich M. The Role of Ketorolac in Decreasing Length of Stay and Narcetic Complications in the Postepection Pediatric Orthopaedic Patient // J. Pedicatr. Orthop. 1999. Vol. 19 (5). P. 688–692. 15. Min K., Pierre P., Ryan P. et al. Elbow. Surg. 2012. PII: S1058–2746 (12) 00372–2. Doi: 10.1016/J.JSE. 2012.08.026. . 16. Lieh-lai M., Kauffman R., Uy H. et al. A RANDOMIZED Comparison of Ketorolac Tromethamine and Morphine for Postoperation Anaalgesia in Critically Ill Children // Crit. Care Med. 1999. Vol. 27 (12). P. 2786–2791. 17. Veenema K., Leahey N., Schneider S. Ketorolac Versus Meperidine: Ed Treatment of Severe Musculoskeletal Low Back Pain // Am. J. Emerg. Med. 2000. Vol. 18 (4). P. 40404–40407. 18. Vertkin A.L., Prokhorovich E.A., Goruleva E.A. and others. The effectiveness and safety of the use of ketorol to stop the pain syndrome at the prehospital stage // Emergency therapy. 2004. No. 1-2; 16–17: 12–17. 19. Shostak N.A., Pravyuk N.G., Aksenova A.V. and other possibilities of optimizing analgesic and anti -inflammatory therapy in patients with acute pain in the back // breast cancer. 2006. No. 14; 8. S. 610–615. 20. Taggart E., Dran S., Kokotillo A. et al. Ketorolac in the Treatment of Acute Migraine: A Systematic Review // Headache. 2013. Vol. 53(2). P. 277–287.

Indications for use of Ketorol

Indications for the use of these tablets are:

• headaches, toothaches;
• joint pain;
• rheumatoid diseases;
• vertebral diseases;
• ligament ruptures, muscle strains;
• radiculitis;
• cancer;
• postoperative period;
• injuries.

The course of treatment lasts up to 5 days, but often one dose is enough to get rid of pain. If long-term treatment is needed, then a break is taken every 12 days, then the drug is resumed.

Possible contraindications

Ketorol should not be taken in the following cases:

• the presence of hypersensitivity to the components of the drug;
• bronchial asthma;
• individual intolerance to acetylsalicylic acid;
• age up to 16 years;
• pregnancy and breastfeeding;
• active bleeding in the gastrointestinal tract;
• chronic inflammation of the intestines and stomach during exacerbation;
• hemorrhagic diathesis;
• heart failure;
• lactose intolerance;
• renal failure;
• stroke;
• stomach ulcer during exacerbation and other symptoms.

Ketorol is used with extreme caution if the patient has a predisposition to cerebrovascular bleeding and edema . It is also prescribed with caution in the presence of diseases such as:

• chronic hypertension;
• coronary heart disease;
• hepatitis;
• sepsis and pustular skin lesions;
• nervous system disorders and somatic diseases;
• diabetes;
• kidney problems.

Doctors do not advise combining the drug with alcoholic drinks , as this can cause intoxication. But other non-steroidal drugs need to be excluded or their amount reduced.

What does it help with and for what pain is it used?

Ketorol (injection) is used for symptomatic treatment of conditions accompanied by severe and moderate pain. The drug has an analgesic effect on receptors located in peripheral structures, so it is prescribed for:

• recovery period after surgery;
• injuries;
• muscle and joint pathologies;
• oncology therapy;
• neuralgia;
• gout;
• rheumatism.

In addition, the drug is prescribed for back pain caused by radiculitis, intervertebral hernia, osteochondrosis, and herpes zoster.

Medicine in tablets is prescribed for:

• migraine;
• algomenorrhea;
• toothache.

Ketorol injection is also given to those who cannot swallow tablets, or if it is necessary to achieve a quick pain-relieving effect. For the symptomatic treatment of dermatological diseases and pain in soft tissues, the use of Ketorol in gel form is recommended.

Indications for use are limited to acute pain. Chronic pain is not treated with Ketorol, since the recommended course of the drug is 5 days.

Manifestations of overdose and its elimination

If the overdose was severe, then the body succumbs to severe intoxication, which manifests itself in the form of symptoms such as:

• stomach ache;
• vomiting and nausea;
• dizziness;
• bleeding in the gastrointestinal tract;
• muscle spasms and cramps;
• apathy;
• speech problems;
• problems with brain activity;
• pressure reduction;
• sweating and coldness in the extremities.

In case of overdose, you need to take the following measures:

• remove the remaining tablets from the internal organs when no more than an hour has passed after taking them by inducing a gag reflex;
• we reduce the concentration of toxins using sorbents (activated carbon, Enterosgel, Sorbex, etc.);
• Provide the patient with water-salt balance - you need to drink at least 2 liters in small sips, but infrequently. For best results, make a saline solution based on salt and soda and sugar. The mixture should be drunk for several days until the side effects completely disappear.

An overdose can occur even with the usual dose of Ketorol when combined with other non-steroidal drugs or together with intramuscular injections . Be sure to read the instructions and follow the dosage.

How to take Ketonal

Pain reliever with anti-inflammatory effect

The drug Ketonal contains the active ingredient ketoprofen. It is one of the most potent inhibitors of the enzyme cycloxygenase, due to which it effectively reduces the level of mediators of the inflammatory reaction in tissues, which include prostaglandins. This leads to a reduction in hyperemia, swelling, and pain. The medication is available in several dosage forms:

• solution for parenteral intravenous or intramuscular administration;
• film-coated tablets;
• capsules for oral administration;
• gel or cream for external use.

For severe lower back pain - lumbago - it is recommended to use a solution for parenteral administration. The injection field must wait for the effect to take place within 15-20 minutes. As the discomfort subsides, you can switch to oral dosage forms of the drug - tablets or capsules. In all cases, simultaneous application of Ketonal cream or gel is allowed.

Ketorol and other drugs at the same time: how they are combined

Taking Ketorol tablets cannot be combined with such drugs as:

• Corticotropins;
• Ethanol;
• acetylsalicylic acid;
• calcium-based vitamins.

All this can provoke heavy bleeding in the gastrointestinal tract and other complex diseases.

When combined with paracetamol, methotrexate and gold-based drugs, Ketorol provokes the development of nephrotoxicity and other serious problems with the excretory system. And if you combine antihypertensive drugs with Ketorol, their effectiveness is reduced. And if the patient has diabetes mellitus, the insulin dose should be adjusted, because Ketorol affects the level of glucose in the blood and its breakdown.

If it is used together with Nefidipine and Verapamil, their concentration increases greatly, which helps in the treatment of myalgia and neuralgia.

What drugs are most dangerous for the heart?

The most dangerous drugs are those that can cause cardiac arrest. Because, in principle, nothing worse can happen to a person than this. Fortunately, there are few such drugs, but they exist. Cardiac arrest, for example, can be caused by cardiac glycosides (digoxin, digitoxin, strophanthin), which are used to treat arrhythmia. Therefore, under no circumstances should you even try to use these medications on your own.

The heart is a muscle, so any drug that affects muscle tissue will also affect the heart. There is a group of drugs called muscle relaxants that relax myocytes (muscle cells). They are used in most cases by anesthesiologists and resuscitators during surgery. However, some of them exist in tablet form.

Also, cardiac arrest can be caused by some psychoactive drugs used to treat serious psychiatric diseases, neuroses, psychoses, etc. They depress the nervous system. And since contraction of the heart requires a regular electrical impulse that excites its various parts, these drugs can lead to serious inhibition of the conduction system of the heart, up to its complete stop. Fortunately, most of these drugs (haloperidol, seduxen, etc.) are not commercially available, so the risk of this complication is low.

Drugs are also medicines. However, their justified use is to relieve severe pain and as one of the components of anesthesia. Self-use of any type of drug may result in cardiac arrest as a result of an overdose of these substances.

What else you need to know about Ketorol

Ketorol is also not recommended for use as anesthesia for minor surgical operations; it can cause bleeding , and it is also best not to use it for chronic pain.

Treatment with this drug in the presence of problems in the circulatory system should be carried out with constant monitoring of the condition and number of platelets and their sedimentation rate. Tests are taken before and after taking the pill.

For cancer, Ketorol can be combined with a small amount of opiates. But it cannot be combined with antitumor drugs, which provokes kidney problems.

Benefits of Ketorol

The key advantages of Ketorol over other drugs are:

• it is used as a safe pain reliever;
• its use does not in any way affect concentration and performance;
• does not have a pronounced sedative effect;
• not capable of causing addiction;
• Ketorol can be used for liver function disorders;
• has no anxiolotic effect;
• affordable price.

And if we talk about the last advantage of Ketorol tablets, then the drug, which is sold in a package with two blisters of 20 tablets, is inexpensive - only about 50 rubles , and the domestic analogue will cost even less. Prices will vary slightly in different first aid kits.

Instructions for use Ketorol

Ketorol, the use of which is advisable only for acute pain syndrome, and not for the treatment of chronic pain, is available in the form of tablets and solution for intramuscular injection.

Depending on the severity of the pain syndrome, Ketorol tablets can be prescribed once or repeatedly.

It is usually recommended to take 10 mg (1 tablet) once, and 10 mg again, but not more than 4 times a day. Taking Ketorol tablets for longer than 5 days is contraindicated.

The injection solution should be administered deeply intramuscularly. For patients under 65 years of age, Ketorol injections are prescribed in a dose of 10-30 mg once or the same dose every 4-6 hours, while the maximum daily dose should not exceed 90 mg. For patients over 65 years of age, Ketorol injections are given according to the scheme described above, with the only difference being that the maximum single dose should be 15 mg, and the maximum daily dose should be 60 mg. Ketorol injections can be used for no longer than 5 days.

When switching from intramuscular administration to oral administration of Ketorol, the total daily doses of the drug should be taken into account: on the day of transition - 30 mg, for patients over 65 years old - 60 mg, for patients under 65 years old - 90 mg.

Best analgesic to relieve discomfort: Ketorol for toothache

Toothache often takes you by surprise.
Before visiting the dentist, painkillers will come to the rescue. Ketorol perfectly relieves an attack of toothache. The strength of this drug is comparable to morphine , and when used correctly it does not cause addiction or severe side effects.

The product is produced in tablets, in the form of an injection solution and gel. In cases of severe pain, patients are most often prescribed tablets - the most convenient form for self-administration.

ontakte

Odnoklassniki

Ketorol is a non-steroidal anti-inflammatory drug. It has a pronounced analgesic property, and also has a weak anti-inflammatory and antipyretic effect.

One of the indications for the use of Ketorol is pain in inflammatory diseases of the oral cavity. In relieving pain caused by pathologies of teeth or gums, Ketorol is more effective than other drugs from the NSAID group.

Composition and pharmacological properties of tablets: does it help?

The active substance of the drug, ketorolac tromethamine, is a derivative of acetic acid.

This component affects a special enzyme in the body - cyclooxygenase, and blocks the production of prostaglandins - substances that provoke pain.

Due to the absence of prostaglandins, the pathological process occurring in the body does not affect the nerve endings and does not cause a response.

The drug also contains glucose, starch, dye and other auxiliary components.

Important! The absence of pain is not a sign of recovery. Ketorol only relieves symptoms and alleviates the condition, but does not stop the destructive processes occurring in the tissues of the tooth and gums. For treatment you need to see a dentist.

The drug is quickly absorbed into the blood. It is advisable not to eat fatty foods before taking the pills, as this reduces their effectiveness. Metabolite substances are excreted through the kidneys.

Photo 1. The drug Ketorol, 20 tablets of 10 mg, from the manufacturer Dr. Reddy's.

Dosage regimen for toothache: how to take it and how long it takes to act

One tablet contains 10 mg of active substance. For adults with severe toothache, it is recommended to take one tablet every 4-6 hours (as the effect of the drug wears off).

The analgesic effect becomes noticeable 30 minutes after administration and reaches a maximum after 1–2 hours.

You should not take additional doses in the hope of enhancing the effect: this will not bring the expected result, but will cause an overdose or provoke side effects.

If the discomfort has subsided, do not rush to put pressure on the aching tooth, chew solid food with it, or eat too hot, cold or concentrated foods. An anesthetic is not a panacea, and pain provoked by external influences will return with renewed vigor.

It is not recommended to consume more than 40 mg of the drug per day ( 4 tablets ). Patients over 65 years of age must maintain an interval of 6–8 hours between doses.

How many days can you drink it and will the remedy help with swelling or not?

The course of using Ketorol should not exceed 7 days.

Longer use can cause disturbances in the functioning of internal organs, in particular the gastrointestinal tract, and abuse of the drug leads to chronic diseases.

Do not forget that painkillers cannot cure a tooth. Pain signals the body about illness, and eliminating this symptom leads to dangerous consequences.

Important! If there is visible tooth decay, pus discharge, bleeding, or swelling of the cheek, do not delay visiting a doctor. Delay will result in tooth loss.

Side effects

Ketorol tablets and injections can provoke such undesirable reactions in patients as:

• diarrhea, stomach pain, vomiting, constipation, flatulence, stomatitis, nausea, heartburn;
• lower back pain, acute renal failure, frequent urination, nephritis (inflammation of the kidneys), decreased or increased volume of urine;
• bronchospasm, laryngeal edema, rhinitis;
• headache, drowsiness, dizziness, hyperactivity, depression, ringing in the ears, hearing loss, blurred vision.
• increased blood pressure, fainting, pulmonary edema;
• leukopenia (increase in white blood cells), eosinophilia (increase in the number of eosinophils), anemia (decrease in the number of red blood cells or hemoglobin);
• rectal, nasal, bleeding from postoperative wounds;
• purpura, skin rash, urticaria, Lyell's syndrome (allergic dermatitis as a reaction to drugs), Stevens-Johnson syndrome (the appearance of blisters on areas of the skin and on the mucous membrane of various organs);
• itching, urticaria, change in complexion, skin rash, swelling of the eyelids, difficulty breathing, wheezing, heaviness in the chest;
• weight gain, swelling of the feet, fingers, ankles, legs, face, tongue, increased sweating, fever;
• pain or burning at the injection site of Ketorol.

Contraindications to the use of Ketorol

According to the instructions, Ketorol is not used to treat chronic pain syndrome. The use of Ketorol is contraindicated for:

• bronchospasm (narrowing of the bronchi as a result of muscle contraction);
• “aspirin” asthma (attacks of asthma associated with taking salicylates);
• hypovolemia (decreased blood volume);
• angioedema (limited deep swelling of the mucous membranes or subcutaneous tissue and skin);
• dehydration (dehydration);
• peptic ulcers (ulceration of the mucous membrane of the esophagus as a result of exposure to gastric juice on one of its segments);
• erosive and ulcerative lesions of the digestive tract in the acute phase;
• hypocoagulation (reduced blood clotting);
• hemorrhagic diathesis (diseases of the blood system, which are characterized by a tendency to increased bleeding);
• hemorrhagic stroke (bleeding in the brain caused by rupture of blood vessels);
• liver or kidney failure;
• concomitant use with other anti-inflammatory non-steroidal drugs;
• hemorrhage disorders;
• high risk of bleeding;
• hypersensitivity to ketorolac or other non-steroidal anti-inflammatory drugs.

Ketorol, the use of which must be discussed with the attending physician, is not prescribed to pregnant and lactating women, as well as children and adolescents under 16 years of age.