Ketorolac

[golf299]

Can anyone explain why ketorolac is only indicated for PO use after it has been given IV or IM? Everything I can find clearly states the above, but give no reason as to why.

The only reason I can think is since it has a high adverse event profile that they want you to be under the supervised care of someone in a hospital setting to initiate therapy, and not have docs just prescribing it for daily use like ibuprofen.

Thanks!

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[NhuY]

I had the same question before....here's the answer 🙂.

Why Must IV/IM Toradol be Given Prior to PO Toradol?
The package insert recommends that PO Toradol® (ketorolac) should only be given after parenteral Toradol® because the PO Toradol® does not work as well if IV or IM is not given first. The parenteral form is meant to be similar to a loading dose. The problem with starting off on PO only is that physicians and patients tend to want to extend therapy beyond 5 days because it does not control pain as well when administered this way. This misuse can increase the potential for adverse effects, such as renal toxicity.

 

[Pharmavixen]

To understand the patho behind AEs from NSAIDs, it helps to know the relative COX 1/COX 2 of these drugs. As a drug becomes more COX II selective, you tend to worry more about CV toxicities. As it becomes more COX I selective, it's the GI you look out for. Ketorolac is the most highly selective COX I agent on the market.

 

[golf299]

If a patient recieves a 5 day course of ketorolac, what is an appropriate time lapse to have before giving ketorolac again for another 5 day course?