Ketorolac contraindications

These drug are contraindicated in individuals with known hypersensitivity to an individual drug or any components of the drug. The NSA.ID flurbiprofen is contraindicated in patients with herpes simplex keratitis. Diclofenac and ketorolac are contraindicated in patients who wear soft contact lenses (may cause ocular irritation). 

Renal effects - Ketorolac is contraindicated in patients with advanced renal impairment and in patients at risk for renal failure because of volume depletion. Risk of bleeding - Ketorolac inhibits platelet function and, therefore, is contraindicated in patients with suspected or confirmed cerebrovascular bleeding, hemorrhagic diathesis, and incomplete hemostasis, and in those at high risk of bleeding. 

Ketorolac is contraindicated as prophylactic analgesia before any major surgery and is contraindicated intra-operatively when hemostasis is critical because of the increased risk of bleeding. 

Concomitant use with NSAiDs - Ketorolac is contraindicated in patients currently receiving aspirin or other NSAIDs ketorolac also is contraindicated with the concomitant use of probenecid. 

Ketorolac Interactions are similar to those of NSAIDs. Ketorolac is contraindicated in patients receiving anticoagulant therapy. Ketorolac should not be administered with probenecid or other NSAIDs. 

Ketorolac tromethamine is contraindicated in patients while wearing soft contact lenses. Caution should be used with patients who have previously exhibited sensitivity to acetylsalicylic acid,phenylacetic acid derivatives, and other NSAIDs because a potential exists for cross-sensitivity. 

Ketorolac (administered as the tromethamine salt Toradol, Ultram) has been used as a short-term alternative (less than 5 days) to opioids for the treatment of moderate to severe pain and is administered intramnscnlarly, intravenously, or orally. Unlike opioids, tolerance, withdrawal, and respiratory depression do not occur. Like other NSAIDs, aspirin sensitivity is a contraindication to the nse of ketorolac. Typical doses are 30 to 60 mg (intramnscnlar), 15 to 30 mg (intravenous), and 5 to 30 mg (oral). Ketorolac is used widely in postoperative patients, but it should not be used for routine obstetric analgesia. Topical (ophthalmic) ketorolac is FDA approved for the treatment of seasonal allergic conjunctivitis and postoperative ocular inflammation after cataract extraction. 

Probenecid reduces the clearance of dexketoprofen, diflunisal, in-dometacin (toxicity seen), ketoprofen, ketorolac, naproxen, sodium meclofenamate, tenoxicam and tiaprofenic acid and raises their levels. Ketorolac and probenecid are specifically contraindicated. The uricosuric effects of probenecid are not affected by in-dometacin but may be slightly reduced by sulindac. 

The interaction between indometacin and probenecid is established and adequately documented. Concurrent use should be well monitored because, while clinical improvement can undoubtedly occur, some patients may develop indometacin toxicity (headache, dizziness, light-headedness, nausea, etc.). This is particularly likely in those with some renal impairment. Reduce the indometacin dosage as necessary. Information about other NSAIDs is limited, but these interactions also appear to be established. The clinical importance of most of them is uncertain, but probably small. Reports of adverse effects seem to be lacking, but it would still be prudent to be alert for any evidence of increased adverse effects. Reduce the NSAID dosage if necessary. The exception is ketorolac, which its manufacturers contraindicate with probenecid because of the marked increases seen in its plasma levels. 

The CSM in the UK and the UK manufacturers say that ketorolac is contraindicated with anticoagulants, including low-dose heparin. Con-... 

The effect of pretreatment with ketorolac on pain during injection of propofol and propofol premixed with lidocaine has been studied in a double-blind, randomized, placebo-controlled trial in 90 ASA I-II patients aged 18-75 years, scheduled for elective plastic surgery and who had no contraindications to propofol or NSAIDs [3Tj. All had a 20-gauge intravenous cannula inserted on the dorsum of the non-dominant hand and were given an infusion of propofol 5 ml/kg/minute after injection of the study... 

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