Analgesic, Nonopioid; Nonsteroidal Anti-inflammatory Drug (NSAID), Oral; Nonsteroidal Anti-inflammatory Drug (NSAID), Parenteral
藥動學
Onset of action: ~30 minutes. Peak effect: ~2 to 3 hours. Duration: 4 to 6 hours. Distribution: Poor penetration into cerebrospinal fluid. Adults: 0.21 L/kg. Protein binding: 99%. Metabolism: Hepatic; undergoes hydroxylation and glucuronide conjugation. Time to peak, serum: 1 to 3 minutes. Excretion: Urine (92%, ~60% as unchanged drug); feces ~6%.
禁忌症
Hypersensitivity to ketorolac, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), or any component of the formulation; active or history of peptic ulcer disease, GI bleeding or perforation, asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs; renal disease; prophylactic analgesic before any major surgery; suspected or confirmed cerebrovascular bleeding, hemorrhagic diathesis, incomplete hemostasis, or high risk of bleeding; concurrent use with aspirin, other NSAIDs, probenecid, or pentoxifylline; use in the setting of coronary artery bypass graft surgery; labor and delivery.
懷孕分類
Maternal use of NSAIDs should be avoided beginning at 20 weeks' gestation; Because NSAIDs may cause premature closure of the ductus arteriosus, prescribing information for ketorolac specifically states use should be avoided starting at 30 weeks' gestation
Migraine, severe, acute treatment (off-label use):
Weight ≥50 kg and <65 years of age: IV: 30 mg once.
Weight <50 kg or ≥65 years of age: IV: 15 mg once. Pain management, acute:
Weight ≥50 kg and <65 years of age: IV: 30 mg as a single dose or 15 to 30 mg every 6 hours as needed; maximum daily dose: 120 mg/day; maximum duration: 5 days.
Weight <50 kg or ≥65 years of age: IV: 15 mg as a single dose or 15 mg every 6 hours as needed; maximum daily dose: 60 mg/day; maximum duration: 5 days.
小兒調整劑量
Pain management (acute; moderately severe): Infants and Children <2 years: 0.5 or 0.25 mg/kg/dose every 6 to 8 hours, not to exceed 48 to 72 hours of treatment; Maximum dose: 15 mg/dose. Children ≥2 years and Adolescents ≤16 years: 0.5 mg/kg/dose every 6 to 8 hours; Maximum dose: 30 mg/dose, usual reported duration: 48 to 72 hours; not to exceed 5 days of treatment.
腎功能調整劑量
eGFR ≥60 mL/minute/1.73 m2: no dosage adjustment necessary. eGFR >30 to <60 mL/minute/1.73 m2: use of analgesics other than nonsteroidal anti-inflammatory drugs may be preferred. If necessary, consider 7.5 to 15 mg every 6 hours.