Ketosin
Description
Ketosin – Ketorolac Tromethamine
Manufacturer: SinoHealth Pharmaceuticals LTD
1. Presentation:
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Tablet: 10 mg
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Injection: 15 mg/ml or 30 mg/ml (IM/IV)
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Eye Drops: 0.4% or 0.5% solution
2. Description / Pharmacology:
Ketorolac Tromethamine is a potent nonsteroidal anti-inflammatory drug (NSAID) belonging to the pyrrolo-pyrrole group.
It provides strong analgesic action comparable to opioids but without central nervous system depression or addiction potential.
Mechanism of action:
Ketorolac inhibits the cyclooxygenase (COX-1 and COX-2) enzyme system, thereby suppressing prostaglandin synthesis — responsible for pain, inflammation, and fever.
At analgesic doses, it has minimal anti-inflammatory effect but excellent pain-relieving efficacy.
Pharmacokinetics:
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Rapidly absorbed following oral or parenteral administration
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Peak plasma concentration within 30–60 minutes
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Highly protein-bound (>99%)
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Metabolized in the liver; excreted primarily via urine
3. Indications:
KETOSIN (Ketorolac Tromethamine) is indicated for:
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Moderate to severe acute postoperative pain
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Musculoskeletal pain, dental pain, or trauma-related pain
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Postpartum uterine cramping or episiotomy pain
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Ocular pain and inflammation following cataract or refractive surgery
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Seasonal allergic conjunctivitis (eye drops form)
রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন।
4. Dosage & Administration:
Oral (Tablet):
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Adults: 10 mg every 4–6 hours as needed.
Maximum dose: 40 mg/day.
Duration: Not to exceed 7 days.
Injection (IM/IV):
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Adults (<65 years): 30 mg every 6 hours (max 120 mg/day).
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Elderly (>65 years), renal impairment, or <50 kg: 15 mg every 6 hours (max 60 mg/day).
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Single-dose IM: 60 mg (<65 years), 30 mg (>65 years).
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Single-dose IV: 30 mg (<65 years), 15 mg (>65 years).
Children (2–16 years):
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IM: 1 mg/kg (max 30 mg)
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IV: 0.5 mg/kg (max 15 mg)
Conversion from injection to tablet:
When switching from parenteral to oral therapy, ensure combined daily total dose (injection + tablet) does not exceed 120 mg in adults or 60 mg in elderly.
Total treatment duration should not exceed 5 days (combined).
Ophthalmic (Eye Drops):
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Adults: 1 drop in each eye 4 times daily.
রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন।
5. Drug Interactions:
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Other NSAIDs / Aspirin: Increase GI and renal toxicity.
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Anticoagulants: Enhanced bleeding risk.
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ACE inhibitors / Beta-blockers: May reduce antihypertensive efficacy.
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Methotrexate: Increases toxicity risk.
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Diuretics: May reduce natriuretic effect.
6. Contraindications:
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Hypersensitivity to Ketorolac or other NSAIDs
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Active peptic ulcer or gastrointestinal bleeding
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Asthma, renal impairment, or dehydration
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Pregnancy and lactation (unless essential)
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Children under 16 years of age
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Use as prophylactic analgesic before surgery
7. Side Effects:
Common adverse effects include:
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Gastrointestinal: Nausea, vomiting, dyspepsia, abdominal pain, GI bleeding, peptic ulcer
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CNS: Headache, dizziness, drowsiness
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Cardiovascular: Hypertension, palpitations, bradycardia
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Others: Rash, fatigue, edema, infertility (rare)
Eye drops may cause temporary burning or stinging upon instillation.
8. Pregnancy & Lactation:
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Pregnancy: Category C – avoid unless clearly needed.
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Lactation: Excreted in breast milk; avoid unless potential benefit outweighs risk.
9. Precautions & Warnings:
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Use with caution in elderly or hepatic dysfunction.
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Avoid in active GI ulcer, bleeding disorders, asthma, or renal disease.
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Long-term or high-dose use increases GI bleeding and renal impairment risk.
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For ophthalmic use, discontinue if corneal epithelial damage occurs.
10. Overdose Effects:
Symptoms: Drowsiness, nausea, vomiting, epigastric pain, GI bleeding, renal impairment.
Treatment:
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Symptomatic and supportive care
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Gastric lavage or activated charcoal if recent ingestion
11. Therapeutic Class:
Non-Opioid Analgesics / Anti-inflammatory Drugs (NSAIDs)
12. Storage Conditions:
Store below 30°C, away from light and moisture.
Keep out of reach of children.




