ketorolac intranasal

Action and Spectrum

Actions and Spectrum 

Cyclooxygenase (COX) enzymes, in particular COX-1 and COX-2, are effectively inhibited by ketorolac intranasal. Ketorolac lowers prostaglandin synthesis, which causes inflammation, discomfort, and fever, by inhibiting COX. The anti-inflammatory and analgesic effects of ketorolac intranasal play a major role in its spectrum of activity.    

Drug Interaction

Adverse Reaction

Frequency defined  

1-10% 

Hypertension (2%) 

Oliguria (3%) 

Rash (3%)   

Increased ALT and/or AST (2%) 

Rhinitis (2%) 

Bradycardia (2%) 

Decreased urine output (2%) 

Increased lacrimation (5%) 

Throat irritation (4%) 

>10% 

Rhinalgia (13%) 

Nasal discomfort (15%) 

Black Box Warning

Black Box Warning 

None

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• People who have a known hypersensitivity to or allergy to ketorolac or other NSAIDs should not take ketorolac intranasal. 
• Patients with a history of asthma, nasal polyps, or angioedema should not use ketorolac intranasal.  

Caution: 

• In patients with pre-existing cardiovascular problems such hypertension, congestive heart failure, and ischemic heart disease, it should be used cautiously. 
• ketorolac intranasal has the potential to cause or exacerbate renal issues, such as acute kidney damage and chronic kidney disease. Patients who have a history of kidney illness or who have compromised kidney function should use it cautiously. 
• Patients with a history of gastrointestinal issues including peptic ulcers or gastrointestinal bleeding, it should be administered with caution. 

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: N/A 

Lactation: Excretion into human milk is known  

Pregnancy Categories:         

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.  

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women. 

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 

Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology  

The cyclooxygenase (COX) enzyme, in particular COX-1 and COX-2, is inhibited by ketorolac intranasal to produce its pharmacological effects. Arachidonic acid is transformed by COX into prostaglandins, which act as mediators of heat, pain, and inflammation. 

Pharmacodynamics 

Prostaglandins make pain receptors more sensitive, intensifying the sensation of pain. ketorolac intranasal lowers pain signaling by reducing the formation of prostaglandins, which has analgesic benefits. It works well for the temporary relief of moderate to severe pain, including post-operative or musculoskeletal discomfort. 

Pharmacokinetics 

Absorption   

ketorolac intranasal is administered directly into the nasal cavity. The nasal mucosa allows the medication to enter the systemic circulation. 

Distribution 

ketorolac intranasal is distributed throughout the body, including inflamed tissues. It has a moderate volume of distribution, indicating that it can penetrate various tissues. 

Metabolism 

The liver is the primary location for ketorolac’s intranasal extensive metabolism. The primary metabolic process involves the chemical reaction known as glucuronidation, in which ketorolac and glucuronic acid are combined to generate ketorolac glucuronide. 

Elimination and excretion 

The elimination of ketorolac intranasal and its metabolites occurs primarily through renal excretion.

Adminstartion

Administration 

ketorolac intranasal is administered directly into the nasal cavity.

Patient Information Leaflet

Patient information leaflet 

Generic Name: ketorolac intranasal 

Why do we use ketorolac intranasal? 

ketorolac intranasal is primarily indicated for the treatment of acute moderate to moderately severe rhinitis, including both seasonal allergic rhinitis (hay fever) and nonallergic rhinitis. ketorolac intranasal can also be used for the treatment of nonallergic rhinitis, which is nasal inflammation not caused by allergies.