PRODUCT DETAILS
Ketorolac tromethamine USP.

Following intramuscular administration, ketorolac tromethamine was rapidly and completely absorbed, a mean peak plasma concentration of 2.2 microgram/ml occurring an average of 50 minutes after a single 30 mg dose.
Toradolin is a potent analgesic agent of the non-steroidal, anti-inflammatory class (NSAID). Its mode of action is to inhibit the cyclo-oxygenase enzyme system and hence prostaglandin synthesis and it demonstrates a minimal anti-inflammatory effect at its analgesic dose.
Toradolin is not an anesthetic agent and possesses no sedative or anxiolytic properties; therefore it is not recommended as a pre-operative medication for the support of anesthesia when these effects are required. It is not an opioid and has no known effects on opioid receptors.

Kinetics in special clinical situations:
Patients with impaired hepatic function from cirrhosis do not have any clinically important changes in ketorolac tromethamine clearance or terminal half life
Indications :
Toradolin ampoules are indicated for the short-term management of moderate to severe acute postoperative pain.

  Dosage and Administration

Toradolin ampoules are for administration by intramuscular or bolus intravenous injection. Bolus intravenous doses should be given over no less than 15 seconds. Toradolin ampoules should not be used for epidural or spinal administration. The time to onset of analgesic effect following both i.v and i.m administration is similar and is approximately 30 minutes, with maximum analgesia occurring within 1 to 2 hrs. The median duration of analgesia is generally 4 to 6 hrs. Dosage should be adjusted according to the severity of the pain and the patient response.

  Side Effects

Elderly patients: For patients over 65 years, the lower end of the dosage range is recommended; a total daily dose of 60 mg should not be exceeded
Children (2 years of age or older):
1.0 mg/kg I.M. or 0.5-1.0 mg/kg I.V followed by 0.5 mg/kg I.V. 6 hourly.
Maximum duration of treatment is 2 days.
Renal impairment: Since ketorolac tromethamine and its metabolites are excreted primarily by the kidney, Toradolin is contraindicated in moderate to severe renal impairment (serum creatinine >160 μmol/l); patients with lesser renal impairment should receive a reduced dose
(not exceeding 60 mg/day i.v. or i.m.), and their renal status should be closely monitored. Even Alfred Angelo has released his own fairytale prom gowns collection for his customers. It means we don’t have to design our own as la princess with our seamstresses. Alfred Angelo himself ensures the elegance of the prom dress design perfectly.
Combination treatment: (See also Incompatibilities) Opioid analgesics (e.g. morphine, pethidine) may be used concomitantly, and may be required for optimal analgesic effect in the early postoperative period when pain is most severe. Ketorolac tromethamine does not interfere
with opioid binding and does not exacerbate opioid-related respiratory depression or sedation. When used in association with Toradolin ampoules, the daily dose of opioid is usually less than that normally required. However, opioid side effects should still be considered, especially in day-case surgery.

  Contraindications

History of peptic ulcer or gastrointestinal bleeding
suspected or confirmed cerebrovascular bleeding
hemorrhagic diatheses, including coagulation disorders
patients with hypersensitivity to ketorolac tromethamine or other NSAIDs and patients in whom aspirin or other prostaglandin synthesis inhibitors induce allergic reactions (severe anaphylactic-like reactions have
been observed in such patients)
patients with the complete or partial syndrome of nasal polyps, angio-edema or bronchospasm
concurrent treatment with other NSAIDs, probenecid or lithium salts
hypovolemia from any cause, or dehydration
moderate or severe renal impairment (serum creatinine >160 μmol/l)
a history of asthma
patients who have had operations with a high risk of hemorrhage or incomplete hemostasis
patients on anticoagulants including low-dose heparin (2,500-5,000 units 12-hourly)
during pregnancy, labor, delivery or lactation

  Over Dosage

Doses of 360 mg given intramuscularly over an 8-hour interval for 5 consecutive days have caused abdominal pain and peptic ulcers which have healed after discontinuation of dosing. Two patients recovered from unsuccessful suicide attempts. One patient experienced nausea after 210 mg Toradolin, and the other hyperventilation after 300 mg Toradolin.

  Storage
  Commercial Pack

Each ampoule contains 30 mg IV/IM Injection
Each pack contains 5 ampoules of 1ml injection

  Others

Toradolin ampoules should not be mixed in a small volume (e.g. in a syringe) with morphine sulphate, pethidine hydrochloride, promethazine hydrochloride or hydroxyzine hydrochloride as precipitation of ketorolac tromethamine will occur. Toradolin ampoules are compatible with normal saline, 5% dextrose, Ringer’s solution, Ringer-Lactate solution or Plasmalyte solution. Compatibility with other drugs is unknown

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