ketorolac ophthalmic (Rx)

Brand and Other Names:Acular, Acular LS, more...Acuvail
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic solution

  • 0.4% (Acular LS)
  • 0.45% (Acuvail)
  • 0.5% (Acular)

Allergic Conjunctivitis

Indicated for temporary relief of ocular itching caused by seasonal allergic conjunctivitis

Acular: Instill 1 gtt in affected eye(s) q6hr

Ocular Pain & Inflammation

Indicated for pain and inflammation following catarac surgery

Acuvail: Instill 1 gtt to affected eye(s) twice daily beginning 1 day before surgery and on day of surgery and continue through the first 2 weeks postoperatively

Acular: Instill 1 gtt 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

Acular LS: Instill 1 gtt in the operated eye PRN for up to 4 days postoperatively

Cystoid Macular Edema (Off-label)

Prevention of postoperatvie cystoid macular edema

1-2 gtt in affected eye(s) q6-8hr beginning 24 hr pre-op and continuing 3-4 wk postoperatively

Dosage Forms & Strengths

ophthalmic solution

  • 0.4% (Acular LS)
  • 0.45% (Acuvail)
  • 0.5% (Acular)

Allergic Conjunctivitis

Indicated for temporary relief of ocular itching caused by seasonal allergic conjunctivitis

<2 years: Safety and efficacy not established

>2 years: Instill 1 gtt in affected eye(s) q6hr (Acular)

Ocular Pain & Inflammation

Indicated for pain and inflammation following catarac surgery

<2 years: Safety and efficacy not established

>2 years: Instill 1 gtt (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: Safety and efficacy not established

>2 years: Instill 1 gtt (Acular LS) in operated eye PRN for up to 4 days postoperatively

Next:

Adverse Effects

>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

Postmarketing reports

Bronchospasm, exacerbation of asthma, and epithelial breakdown

Previous
Next:

Warnings

Contraindications

Hypersensitivity to ASA, NSAIDs, or ingredients in the formulation

Cautions

Ocular infection possible following surgery; patients should use two bottles should not use the same bottle for both eyes

Safety and efficacy of Acular LS not established in postcataract surgery patients

NSAIDs may delay healing

Cross-sensitivity or hypersensitivity may occur between other NSAIDs, acetylsalicylic acid, and phenylacetic acid derivatives

Increased bleeding time due to interference with thrombocyte aggregation; reports that ocularly applied NSAIDs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery

May cause keratitis, and in some susceptible patients, chronic use may cause epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration, or corneal perforation

Do not administer while wearing contact lenses

Do not allow the tip of the bottle to contact the eye or surrounding structures because this could cause the tip to become contaminated by common bacteria known to cause ocular infections; serious damage to the eye and subsequent loss of vision may result from using contaminated solutions

Previous
Next:

Pregnancy & Lactation

Pregnancy Category: C

Lactation: Unknown; use with caution

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Previous
Next:

Pharmacology

Mechanism of Action

Nonsteroidal anti-inflammatory agent; reduces production of prostaglandin precursors by inhibiting COX-1 and COX-2; has anti-inflammatory properties

Previous
Next:

Images

BRAND FORM. UNIT PRICE PILL IMAGE
ketorolac injection
-
30 mg/mL (1 mL) vial
ketorolac injection
-
30 mg/mL (1 mL) vial
ketorolac injection
-
15 mg/mL vial
ketorolac injection
-
15 mg/mL vial
ketorolac injection
-
30 mg/mL (1 mL) vial
ketorolac injection
-
30 mg/mL (1 mL) vial
ketorolac injection
-
30 mg/mL vial
ketorolac injection
-
15 mg/mL vial
ketorolac injection
-
15 mg/mL vial
ketorolac injection
-
30 mg/mL (1 mL) vial
ketorolac injection
-
30 mg/mL (1 mL) vial
ketorolac injection
-
15 mg/mL solution
ketorolac injection
-
30 mg/mL solution
ketorolac injection
-
30 mg/mL (1 mL) vial
ketorolac injection
-
15 mg/mL vial
ketorolac injection
-
30 mg/mL solution
ketorolac injection
-
30 mg/mL (1 mL) vial
ketorolac injection
-
15 mg/mL vial
ketorolac injection
-
30 mg/mL solution
ketorolac injection
-
30 mg/mL (1 mL) vial
ketorolac ophthalmic (eye)
-
0.4 % drops
ketorolac ophthalmic (eye)
-
0.5 % drops
ketorolac ophthalmic (eye)
-
0.5 % drops
ketorolac ophthalmic (eye)
-
0.5 % drops
ketorolac ophthalmic (eye)
-
0.5 % drops
ketorolac ophthalmic (eye)
-
0.5 % drops
ketorolac ophthalmic (eye)
-
0.5 % drops
ketorolac ophthalmic (eye)
-
0.5 % drops
ketorolac ophthalmic (eye)
-
0.5 % drops
ketorolac ophthalmic (eye)
-
0.5 % drops
ketorolac ophthalmic (eye)
-
0.5 % drops
ketorolac ophthalmic (eye)
-
0.5 % drops
Acular LS ophthalmic (eye)
-
0.4 % drops
ketorolac intramuscular
-
60 mg/2 mL vial
ketorolac intramuscular
-
60 mg/2 mL vial
ketorolac intramuscular
-
60 mg/2 mL vial
ketorolac intramuscular
-
60 mg/2 mL vial
ketorolac intramuscular
-
60 mg/2 mL vial
ketorolac intramuscular
-
60 mg/2 mL vial
ketorolac intramuscular
-
60 mg/2 mL vial
ketorolac intramuscular
-
60 mg/2 mL solution
ketorolac intramuscular
-
60 mg/2 mL vial
ketorolac intramuscular
-
60 mg/2 mL vial
ketorolac intramuscular
-
60 mg/2 mL solution
Sprix nasal
-
15.75 mg/spray liquid
Sprix nasal
-
15.75 mg/spray liquid
ketorolac nasal
-
15.75 mg/spray liquid
Acular ophthalmic (eye)
-
0.5 % drops
ketorolac oral
-
10 mg tablet
ketorolac oral
-
10 mg tablet

Copyright © 2010 First DataBank, Inc.

Previous
Next:

Patient Handout

Select a drug:
Patient Education
ketorolac injection

KETOROLAC - INJECTION

(KEE-toe-ROLE-ak)

COMMON BRAND NAME(S): Toradol

WARNING: It is important that you use this medication properly to help reduce your risk of side effects. Your doctor may adjust your dose if you are older, have low body weight, or have kidney problems.Nonsteroidal anti-inflammatory drugs (including ketorolac) may rarely increase the risk for a heart attack or stroke. This effect can happen at any time while using this drug but is more likely if you use it for a long time. The risk may be greater in older adults or if you have heart disease or increased risk for heart disease (for example, due to smoking, family history of heart disease, or conditions such as high blood pressure or diabetes). Talk to your doctor about the benefits and risks of using this drug.This drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. This effect can occur without warning at any time while using this drug. Older adults may be at higher risk for this effect. Do not use this medication if you have stomach/intestinal problems (such as bleeding, ulcers).Stop using ketorolac and seek immediate medical attention if you notice any of the following rare but serious side effects: bloody or black/tarry stools, persistent stomach/abdominal pain, vomit that looks like coffee grounds, chest/jaw/left arm pain, shortness of breath, unusual sweating, weakness on one side of the body, sudden vision changes, trouble speaking.Do not use this drug right before or after heart bypass surgery (CABG) or before any surgery. It also should not be used during labor/delivery or in people with severe kidney problems or high risk for kidney problems. Do not use ketorolac if you are taking high doses of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). See also Drug Interactions section.

USES: Ketorolac is used for the short-term treatment of moderate to severe pain. It is usually used before or after medical procedures or after surgery. Reducing pain helps you recover more comfortably so that you can return to your normal daily activities. This medication is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation. This effect helps to decrease swelling, pain, or fever.Ketorolac should not be used for mild or long-term painful conditions (such as arthritis).

HOW TO USE: Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using ketorolac. If you have any questions, ask your doctor or pharmacist.This medication is given by injection into a muscle or vein as directed by your doctor. It may be given as a one-time dose or given on a regular schedule. If given on a regular schedule, it is usually injected every 6 hours as needed, or as directed by your doctor. This drug must not be injected into the spine.Dosage is based on your medical condition and response to treatment. To reduce your risk of stomach bleeding and other side effects, use this medication at the lowest effective dose for the shortest possible time. Do not increase your dose, use it more frequently, or use it for longer than 5 days. If you still have pain after 5 days, talk with your doctor about other medications you may use.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.If you have "breakthrough" pain while using this medication, ask your doctor about other medications that you can use with this drug. Tell your doctor if your condition worsens or if your pain is not relieved.

SIDE EFFECTS: See also Warning section.Pain at the injection site, dizziness, drowsiness, headache, or upset stomach may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: fainting, fast/pounding heartbeat, hearing changes (such as ringing in the ears), mental/mood changes (such as confusion, depression), persistent/severe headache, stomach pain, vision changes (such as blurred vision), easy bruising/bleeding, signs of kidney problems (such as change in the amount of urine), signs of infection (such as fever, chills, persistent sore throat), symptoms of meningitis (such as unexplained stiff neck, fever), symptoms of heart failure (such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).This drug may rarely cause serious (possibly fatal) liver disease. Get medical help right away if you have any symptoms of liver damage, including: dark urine, stomach/abdominal pain, persistent nausea/vomiting, yellowing eyes/skin.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using ketorolac, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other nonsteroidal anti-inflammatory drugs-NSAIDs (such as ibuprofen, naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), bleeding or clotting problems, blood disorders (such as anemia), heart disease (such as previous heart attack), high blood pressure, liver disease, growths in the nose (nasal polyps), throat/stomach/intestinal problems (such as bleeding, heartburn, ulcers), stroke, swelling of the ankles/feet/hands.Kidney problems can sometimes occur with the use of NSAID medications, including ketorolac. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have a change in the amount of urine.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medicine may cause stomach/intestinal bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be at greater risk for stomach/intestinal bleeding, kidney problems, heart attack, and stroke while using this drug.Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks. Tell your doctor if you are pregnant or if you plan to become pregnant. This medication may harm an unborn baby and cause problems with normal labor/delivery. It is not recommended for use in pregnancy from 20 weeks until delivery. If your doctor decides that you need to use this medication between 20 and 30 weeks of pregnancy, you should use the lowest effective dose for the shortest possible time. You should not use this medication after 30 weeks of pregnancy.This drug passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as valsartan, losartan), corticosteroids (such as prednisone), methotrexate, probenecid, other medications that may affect the kidneys (including cidofovir), "water pills" (diuretics such as furosemide).This medication may increase the risk of bleeding when used with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.This medication can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include lithium, pemetrexed, among others.Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen or naproxen). These drugs are similar to ketorolac and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe stomach pain, vomit that looks like coffee grounds, extreme drowsiness, slow/shallow breathing.

NOTES: Do not share this medication with others.Keep all regular medical and laboratory appointments. Laboratory and/or medical tests (including blood pressure, kidney function tests) may be performed to check for side effects. Consult your doctor for more details.This medication has been prescribed for your current condition only. Do not use it later for another condition unless your doctor directs you to do so. A different medication may be necessary in that case.

MISSED DOSE: It is important to get each dose of this medication as scheduled. If you are using this drug on a regular schedule (not "as needed") and you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Previous
Next:

Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
Additional Offers
Email to Patient

From:

To:

The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Email Forms to Patient

From:

To:

The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Previous
Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.