Ketorolac

A powerful short-term NSAID used for moderate to severe pain, often as an alternative to opioids.

What is Ketorolac?

Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) known for its strong analgesic (pain-relieving) action. It is commonly used for short-term management of moderate to severe pain, especially after surgery or injury.

Unlike most NSAIDs, ketorolac is often compared to low-dose opioids in terms of pain relief, but without the risk of dependence.

History & Development

Ketorolac was developed in the late 1980s to provide strong pain relief without the addictive potential of opioids. It quickly became popular in hospitals for post-operative pain control.

Chemical Structure & Properties

• IUPAC name: (±)-5-benzoyl-2,3-dihydro-1H-pyrrolizine-1-carboxylic acid
• Molecular formula: C₁₅H₁₃NO₃
• Molar mass: 255.27 g/mol
• Functional groups: Carboxylic acid, aromatic ketone

Its structure allows strong inhibition of COX enzymes, resulting in potent analgesic effects.

Mechanism of Action

Ketorolac works by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), leading to reduced prostaglandin synthesis. This results in:

• Strong reduction in pain perception
• Moderate anti-inflammatory action
• Reduction of fever

It has a higher COX-1 inhibition compared to some NSAIDs, explaining both its potency and side-effect profile.

Pharmacokinetics

• Absorption: Rapid (oral, IM, IV)
• Peak plasma time: 30–60 minutes
• Protein binding: ~99%
• Half-life: 4–6 hours
• Metabolism: Liver
• Excretion: Mainly urine

Medical Uses

• Post-operative pain
• Renal colic
• Musculoskeletal injuries
• Dental pain (severe)
• Acute migraine attacks

Dosage Guidelines

Adults (oral): 10 mg every 4–6 hours

Maximum daily dose: 40 mg

⚠️ Maximum duration of use: 5 days only

Side Effects

• Gastric irritation
• Nausea
• Dizziness
• Headache

Serious Risks & Warnings

• Gastrointestinal bleeding
• Kidney failure (especially in dehydration)
• Bleeding risk due to platelet inhibition

Drug Interactions

• Other NSAIDs
• Blood thinners
• Corticosteroids
• Diuretics

Ketorolac vs Diclofenac

Ketorolac is preferred for short-term severe pain, while diclofenac is better suited for chronic inflammatory conditions.

Frequently Asked Questions

Is ketorolac stronger than ibuprofen? – Yes.

Can ketorolac replace opioids? – In some acute pain cases, yes.

Is it safe for long-term use? – No.

Is ketorolac an antibiotic? – No.

⚠️ Educational content only. Not a substitute for professional medical advice.