Ketorolac Tromethamine 0.5% Eye prep

Indications

Ketorolac Tromethamine 0.5% Eye prep is used for: Allergic conjunctivitis, Postoperative eye inflammation, Cystoid macular oedema

Adult Dose

Allergic Conjunctivitis Indicated for temporary relief of ocular itching caused by seasonal allergic conjunctivitis Instill 1 drop in affected eye(s) q6hr Ocular Pain & Inflammation Indicated for pain and inflammation following catarac surgery Instill 1 drop in affected eye(s) four times daily starting 24 hr after surgery and continue up to 4 days after surgery Ocular Pain & Burning/Stinging Indicated to reduce ocular pain and burning/stinging following corneal refractive surgery Instill 1 drop in the operated eye PRN for up to 4 days postoperatively

Child Dose

<2 years: Safety and efficacy not established Allergic Conjunctivitis Indicated for temporary relief of ocular itching caused by seasonal allergic conjunctivitis >2 years: Instill 1 drop in affected eye(s) q6hr (Acular) Ocular Pain & Inflammation >2 years: Instill 1 drop (Acular) in affected eye(s) q6hr starting 24 hr after surgery and continue through the first 2 weeks postoperatively Ocular Pain & Burning/Stinging Indicated to reduce ocular pain and burning/stinging following corneal refractive surgery >2 years: Instill 1 drop (Acular LS) in operated eye PRN for up to 4 days postoperatively

Renal Dose

Administration

Contra Indications

Ketorolac Tromethamine is contraindicated in patients with known hypersensitivity to NSAIDs and any of the components of Ketorolac Tromethamine. Moreover, the patient with the history of asthma, nasal polyp, angioedema, peptic ulcer and bleeding, bleeding disorders are contraindicated for this drug.

Precautions

Elderly, hepatic dysfunction, heart failure, predisposition to reduced blood volume or renal blood flow. Mild renal impairment; monitor renal function closely. Lactation: Unknown; use with caution

Pregnancy-Lactation

Pregnancy Category: C Lactation: Unknown; use with caution

Interactions

May reduce effects of antihypertensives eg ACE inhibitors or angiotensin II receptor antagonists (AIIA). Increased risk of renal toxicity with ACE inhibitors, diuretics. Increased adverse effects with aspirin or other NSAIDs. Hallucinations may occur when used with fluoxetine, thiothixene, alprazolam. Potentially Fatal: Increased risk of GI bleeding with warfarin. May increase toxicity of methotrexate (MTX) and lithium. Increased plasma concentrations with probenecid.

Adverse Effects

Side effects of Ketorolac Tromethamine 0.5% Eye prep : >10% Transient ocular burning/stinging 1-10% Conjunctival hyperemia, Corneal edema, Iritis, Corneal infiltrates, Iritis, Corneal edema, Ocular inflammation, Ocular irritation, Ocular pain, Increased ocular pressure, Superficial keratitis, Superficial ocular infection <1% Blurred vision, Corneal ulcer, Corneal erosion, Corneal thinning, Perforation of cornea, Dry eyes, Epithelial breakdown, Corneal epithelial degeneration

Mechanism of Action

Ketorolac inhibits prostaglandin synthesis by decreasing the activity of the cyclooxygenase enzyme.