Online PLR Content Marketing Saint Vincent and the Grenadines: ketorolac Nasal

kee-toe-ROLE-ak

Nasal route(Spray)

For short term use only (up to 5 days in adults). Not for use in pediatric patients and not indicated for minor or chronic pain. Contraindicated in patients with peptic ulcer disease, history of gastrointestinal (GI) bleeding or perforation, peri-operative pain in the setting of CABG surgery, advanced renal impairment, risk of renal failure due to volume depletion, cerebrovascular bleeding, hemorrhagic diathesis, incomplete homeostasis, and high risk of bleeding. Use caution with elderly patients due to high risk of GI adverse events and in patients with cardiovascular disease or risk factors for cardiovascular disease .

Commonly used brand name(s)

In the U.S.

Sprix

Available Dosage Forms:

Spray

Pharmacologic Class: NSAID

Chemical Class: Acetic Acid (class)

Uses For ketorolac

Ketorolac nasal spray is used to relieve moderate to moderately severe pain, such as pain that occurs after an operation or other painful procedure. It is a nonsteroidal anti-inflammatory drug (NSAID) that will reduce pain and inflammation.

Ketorolac has side effects that can be very dangerous. The risk of having a serious side effect increases with the amount that is used and the length of time it is used. Ketorolac should not be used for more than 5 days in a row. Before using ketorolac, you should discuss with your doctor the good that ketorolac can do as well as the risks of using it.

ketorolac is available only with your doctor's prescription.

Before Using ketorolac

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ketorolac, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ketorolac or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of ketorolac nasal spray in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ketorolac nasal spray in the elderly. However, because of ketorolac's toxicity, it should be used with caution in the elderly, after less toxic alternatives have been considered or found ineffective. Recommended doses should not be exceeded, and the patient should be carefully monitored during treatment. In addition, elderly patients are more likely to have age-related heart, kidney, liver, stomach, or bowel problems, which may require caution and an adjustment in the dose for patients receiving ketorolac nasal spray.

Pregnancy

	Pregnancy Category	Explanation
1st Trimester	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.
2nd Trimester	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.
3rd Trimester	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ketorolac, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ketorolac with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Aceclofenac

Acemetacin

Alclofenac

Apazone

Aspirin

Benoxaprofen

Bufexamac

Carprofen

Clometacin

Clonixin

Dexketoprofen

Diclofenac

Diflunisal

Dipyrone

Droxicam

Etodolac

Etofenamate

Felbinac

Fenbufen

Fenoprofen

Fentiazac

Floctafenine

Flufenamic Acid

Flurbiprofen

Ibuprofen

Indomethacin

Indoprofen

Isoxicam

Ketoprofen

Lornoxicam

Meclofenamate

Mefenamic Acid

Meloxicam

Nabumetone

Naproxen

Niflumic Acid

Nimesulide

Oxaprozin

Oxyphenbutazone

Pentoxifylline

Phenylbutazone

Pirazolac

Piroxicam

Pirprofen

Probenecid

Propyphenazone

Proquazone

Sulindac

Suprofen

Tenidap

Tenoxicam

Tiaprofenic Acid

Tolmetin

Zomepirac

Using ketorolac with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abciximab

Ardeparin

Argatroban

Beclamide

Beta Glucan

Bivalirudin

Caramiphen

Carbamazepine

Certoparin

Chlormethiazole

Cilostazol

Citalopram

Clopidogrel

Clovoxamine

Dabigatran Etexilate

Dalteparin

Danaparoid

Desirudin

Diazepam

Dipyridamole

Enoxaparin

Escitalopram

Ethotoin

Felbamate

Femoxetine

Flesinoxan

Fluoxetine

Fluvoxamine

Fondaparinux

Fosphenytoin

Gabapentin

Ginkgo

Heparin

Lacosamide

Lepirudin

Levetiracetam

Mephenytoin

Mephobarbital

Methotrexate

Nadroparin

Nefazodone

Oxcarbazepine

Paraldehyde

Paramethadione

Parnaparin

Paroxetine

Pemetrexed

Phenacemide

Phenobarbital

Phenytoin

Piracetam

Pregabalin

Protein C

Reviparin

Rivaroxaban

Rufinamide

Sertraline

Sibutramine

Stiripentol

Tacrolimus

Tiagabine

Ticlopidine

Tinzaparin

Tirofiban

Topiramate

Trimethadione

Valproic Acid

Vigabatrin

Vilazodone

Zimeldine

Zonisamide

Using ketorolac with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acebutolol

Acetohexamide

Alacepril

Alprenolol

Amiloride

Arotinolol

Atenolol

Azilsartan Medoxomil

Azosemide

Befunolol

Bemetizide

Benazepril

Bendroflumethiazide

Benzthiazide

Betaxolol

Bevantolol

Bisoprolol

Bopindolol

Bucindolol

Bumetanide

Bupranolol

Buthiazide

Candesartan Cilexetil

Canrenoate

Captopril

Carteolol

Carvedilol

Celiprolol

Chlorothiazide

Chlorpropamide

Chlorthalidone

Cilazapril

Clopamide

Cyclopenthiazide

Cyclosporine

Delapril

Desvenlafaxine

Dilevalol

Duloxetine

Enalaprilat

Enalapril Maleate

Eprosartan

Esmolol

Ethacrynic Acid

Fosinopril

Furosemide

Gliclazide

Glimepiride

Glipizide

Gliquidone

Glyburide

Hydrochlorothiazide

Hydroflumethiazide

Imidapril

Indapamide

Irbesartan

Labetalol

Landiolol

Levobetaxolol

Levobunolol

Lisinopril

Lithium

Losartan

Mepindolol

Methyclothiazide

Metipranolol

Metolazone

Metoprolol

Milnacipran

Moexipril

Nadolol

Nebivolol

Nipradilol

Olmesartan Medoxomil

Oxprenolol

Penbutolol

Pentopril

Perindopril

Pindolol

Piretanide

Polythiazide

Propranolol

Quinapril

Ramipril

Sotalol

Spirapril

Spironolactone

Talinolol

Tasosartan

Telmisartan

Temocapril

Tertatolol

Timolol

Tolazamide

Tolbutamide

Torsemide

Trandolapril

Triamterene

Trichlormethiazide

Valsartan

Venlafaxine

Xipamide

Zofenopril

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of ketorolac

Take ketorolac only as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Do not use it for more than 5 days in a row. The total number of days also includes any doses of ketorolac that may be given in a hospital or clinic setting. Using too much of ketorolac increases the chance of side effects, especially in elderly patients.

ketorolac should come with a medication guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

ketorolac is only used in the nose. Do not get any of it in your eyes. If it does get in the eyes, rinse them with water right away and call your doctor.

Drink extra fluids while you are using ketorolac. This will keep your kidneys working well and help prevent kidney problems.

To use:

If you are using the nasal spray for the first time, you will need to prime the spray. To do this, pump the bottle five times until some of the medicine sprays out. Now it is ready to use.

Gently blow your nose to clear the nostrils.

Sit or stand up straight and tilt your head slightly forward.

Insert the tip of the bottle into your right nostril. Point the bottle away from the center of your nose.

Spray once into your right nostril. If your dose is 2 sprays, spray once into your left nostril the same way.

After using the spray, wipe the tip of the bottle with a clean tissue and put the clear plastic cover back on.

Do not use the bottle for more than 24 hours after your first dose. Throw the bottle away after 24 hours even if it still has liquid in it.

Dosing

The dose of ketorolac will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ketorolac. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For nasal dosage form (spray):
- For pain:
  - Adults weighing 50 kilograms (kg) or more—31.5 milligrams (mg) or 1 spray in each nostril every 6 to 8 hours. Your doctor may adjust your dose if needed. However, the dose is usually not more than 126 mg (a total of 8 sprays) per day.
  - Older adults and adults weighing less than 50 kg—15.75 mg or 1 spray in only one nostril every 6 to 8 hours. However, the dose is usually not more than 63 mg (a total of 4 sprays) per day.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of ketorolac, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Keep the unopened bottle in the refrigerator. Protect it from light and freezing. Once opened, store the bottle at room temperature, away from heat and direct sunlight. Throw away any unused medicine 24 hours after you opened the bottle and used your first dose.

Precautions While Using ketorolac

It is very important that your doctor check your progress while you are using ketorolac. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to use it.

Do not use any other form of ketorolac (such as injection or tablets) or other NSAIDs unless your doctor says it is okay. Some examples of NSAIDs are aspirin, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Ecotrin®, Motrin®, or Voltaren®. Also, you should not use ketorolac together with pentoxifylline (Trental®) or probenecid (Benemid®).

Ketorolac may cause bleeding in your stomach or intestines. This problem can happen without warning signs. This is more likely if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, if you are over 60 years of age, are in poor health, or are using certain other medicines (such as steroids or a blood thinner). Stop using ketorolac and call your doctor right away if you have bloody or black, tarry stools; severe stomach pain or heartburn; or vomiting of blood or material that looks like coffee grounds.

ketorolac may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth while you are using ketorolac.

Ketorolac may increase your risk of having a heart attack. This is more likely in people who already have heart disease. Stop using ketorolac and call your doctor right away if you have chest pain or discomfort; an irregular or fast heart beat; severe indigestion or heartburn; nausea; sweating; or troubled breathing with exertion.

Serious skin reactions can occur during treatment with ketorolac. Stop using ketorolac and check with your doctor right away if you have any of the following symptoms while you are using ketorolac: blistering, peeling, loosening of the skin; chills; cough; diarrhea; fever; itching; joint or muscle pain; red skin lesions; sore throat; sores, ulcers, or white spots in the mouth or on the lips; or unusual tiredness or weakness.

Check with your doctor right away if you have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

ketorolac Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Abdominal or stomach pain, cramping, or burning

bloody or black, tarry stools

blurred vision

constipation

diarrhea

dizziness

fast, irregular, pounding, or racing heartbeat or pulse

headache

heartburn

indigestion

nausea

nervousness

pale skin

pounding in the ears

severe stomach pain

sweating

unusual bleeding or bruising

unusual tiredness or weakness

vomiting of blood or material that looks like coffee grounds

Less common

Burning feeling in the chest or stomach

chest pain or discomfort

decrease in amount or frequency of urine

difficult or labored breathing

frequent urge to urinate

frequent urination

increased amount of pale, dilute urine

lightheadedness, dizziness, or fainting

rapid, shallow breathing

shortness of breath

troubled breathing with exertion

Rare

Bleeding gums

bloody or cloudy urine

blue lips and fingernails

chills

clay-colored stools

confusion

cough or hoarseness

coughing that sometimes produces a pink frothy sputum

dark urine

difficult, burning, or painful urination

difficulty with swallowing

dilated neck veins

extreme fatigue

general tiredness and weakness

increased blood pressure

increased sweating

increased thirst

itching or hives

light-colored stools

lower back or side pain

nosebleeds

pain or burning in the throat

pinpoint red spots on the skin

rash

rectal bleeding

sores, ulcers, or white spots on the lips or tongue or inside the mouth

stomach upset

swelling of the face, fingers, feet, or lower legs

swollen glands

tenderness in the stomach area

tightness in the chest

unpleasant breath odor

upper right abdominal pain

vomiting

weight gain or loss

wheezing

yellow eyes or skin

Incidence not known

Blistering, peeling, or loosening of the skin

bloating

change in consciousness

convulsions

difficulty with moving

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

feeling of warmth

feeling that others are watching you or controlling your behavior

feeling, seeing, or hearing things that are not there

fever with or without chills

general body swelling

joint or muscle pain

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

loss of consciousness

muscle aching or cramping

muscle pains or stiffness

pain or discomfort in the arms, jaw, back, or neck

pains in the stomach, side, or abdomen, possibly radiating to the back

pale or blue lips, fingernails, or skin

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

red skin lesions, often with a purple center

red, irritated eyes

redness of the face, neck, arms, and occasionally, upper chest

redness, soreness, or itching skin

severe mood or mental changes

sneezing

sores, welting, or blisters

swollen joints

swollen, painful, or tender lymph glands in the neck, armpit, or groin

weakness or heaviness of the legs

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Acid or sour stomach

belching

continuing ringing or buzzing or other unexplained noise in the ears

drowsiness

excess air or gas in the stomach or intestines

full feeling

hearing loss

nasal discomfort

passing gas

swelling or inflammation of the mouth

Less common

Runny nose

stuffy nose

watering of the eyes

Rare

Abnormal dreams

abnormal taste

appetite changes

bloody nose

bruising

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

decreased awareness or responsiveness

delusions

dementia

difficulty with speaking

drooling

excessive thirst

false or unusual sense of well-being

feeling of constant movement of self or surroundings

feeling sad or empty

general feeling of discomfort or illness

inability to concentrate

increase in body movements

irritability

lack or loss of strength

large, flat, blue, or purplish patches in the skin

loss of balance control

loss of interest or pleasure

muscle trembling, jerking, or stiffness

redness, swelling, or soreness of the tongue

restlessness

seeing, hearing, or feeling things that are not there

sensation of spinning

shakiness in the legs, arms, hands, or feet

shuffling walk

sleepiness or unusual drowsiness

sleeplessness

tiredness

trouble concentrating

trouble sleeping

uncontrolled movements, especially of the face, neck, and back

weight loss

Incidence not known

Burning, dry, or itching eyes

eye discharge or excessive tearing

flushed, dry skin

fruit-like breath odor

increased hunger

increased urination

redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid

stiff neck or back

unexplained weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Online PLR Content Marketing Saint Vincent and the Grenadines

Friday, September 28, 2012

ketorolac Nasal