Identification

Name
Ketorolac
Accession Number
DB00465  (APRD01060)
Type
Small Molecule
Groups
Approved
Description

A pyrrolizine carboxylic acid derivative structurally related to indomethacin. It is an NSAID and is used principally for its analgesic activity. (From Martindale The Extra Pharmacopoeia, 31st ed)

Structure
Thumb
Synonyms
  • (+-)-5-Benzoyl-2,3-dihydro-1H-pyrrolizine-1-carboxylic acid
  • (+-)-Ketorolac
  • Ketorolac
  • Kétorolac
  • Ketorolaco
  • Ketorolacum
  • rac-Ketorolac
External IDs
BPPC
Product Ingredients
IngredientUNIICASInChI Key
Ketorolac tromethamine4EVE5946BQ74103-07-4BWHLPLXXIDYSNW-UHFFFAOYSA-N
Product Images
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
AcularSolution / drops5 mg/1mLOphthalmicAllergan1992-12-01Not applicableUs
AcularSolution5 mg/1mLOphthalmicRebel Distributors1992-11-09Not applicableUs
AcularSolution / drops50 mg/1mLOphthalmicPhysicians Total Care, Inc.2002-10-172011-06-30Us
AcularSolution / drops5 mg/1mLOphthalmicStat Rx USA1992-12-01Not applicableUs
Acular Liq 0.5%Solution0.5 %OphthalmicAllergan1992-12-31Not applicableCanada
Acular LsSolution0.4 %OphthalmicAllergan2004-03-08Not applicableCanada
Acular LsSolution / drops4 mg/1mLOphthalmicAllergan2003-08-19Not applicableUs
Acular LsSolution40 mg/1mLOphthalmicPhysicians Total Care, Inc.2003-09-042011-06-30Us
Acular PFSolution / drops5 mg/1mLOphthalmicAllergan1998-01-082011-06-10Us
AcuvailSolution / drops4.5 mg/1mLOphthalmicAllergan2009-08-01Not applicableUs
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Acunivive 30Injection, solution30 mg/1mLIntramuscular; IntravenousIt3 Medical Llc2017-03-01Not applicableUs
Acunivive 60Injection, solution30 mg/1mLIntramuscularIt3 Medical Llc2017-03-01Not applicableUs
Apo-ketorolacTablet10 mgOralApotex Corporation1998-07-03Not applicableCanada
Apo-ketorolac InjectableSolution30 mgIntramuscularApotex Corporation2001-12-04Not applicableCanada
KetorolacTablet, film coated10 mg/1OralStat Rx USA2010-09-15Not applicableUs00378 1134 01 nlmimage10 dc3eee57
Ketorolac TromethamInjection, solution60 mg/2mLIntramuscularHF Acquisition Co LLC, DBA HealthFirst2018-09-19Not applicableUs
Ketorolac TromethamInjection, solution30 mg/1mLIntramuscularHF Acquisition Co LLC, DBA HealthFirst2018-09-19Not applicableUs
Ketorolac TromethamineTablet, film coated10 mg/1OralAidarex Pharmaceuticals LLC1998-06-17Not applicableUs
Ketorolac TromethamineSolution5 mg/1mLOphthalmicProficient Rx LP2009-11-05Not applicableUs
Ketorolac TromethamineInjection, solution30 mg/1mLIntramuscular; IntravenousProficient Rx LP2017-01-15Not applicableUs
Over the Counter Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Toradol Tab 10mgTablet10 mgOralSyntex Inc.1991-12-311996-09-30Canada
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
Acunistat-30Ketorolac tromethamine (30 mg/1mL) + Isopropyl Alcohol (0.7 mL/1mL) + Lidocaine hydrochloride (10 mg/1mL)KitIt3 Medical Llc2017-03-01Not applicableUs
Acunistat-60Ketorolac tromethamine (30 mg/1mL) + Isopropyl Alcohol (0.7 mL/1mL) + Lidocaine hydrochloride (10 mg/1mL)KitIt3 Medical Llc2017-03-01Not applicableUs
Acunivive 90Ketorolac tromethamine (30 mg/1mL) + Ketorolac tromethamine (30 mg/1mL) + Isopropyl Alcohol (0.7 mL/1mL)KitIt3 Medical Llc2017-03-01Not applicableUs
Acunivive 90Ketorolac tromethamine (30 mg/1mL) + Ketorolac tromethamine (30 mg/1mL) + Isopropyl Alcohol (0.7 mL/1mL)KitIt3 Medical Llc2017-03-01Not applicableUs
OmidriaKetorolac (2.88 mg/1mL) + Phenylephrine (10.16 mg/1mL)Injection, solution, concentrateIntraocularOmeros Corporation2014-06-13Not applicableUs
ReadySharp Anesthetics plus KetorolacKetorolac tromethamine (15 mg/1mL) + Bupivacaine hydrochloride monohydrate (5 mg/1mL) + Lidocaine hydrochloride (10 mg/1mL)KitEpidural; Infiltration; Intramuscular; IntravenousTerrain Pharmaceuticals2015-12-29Not applicableUs
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
Chi-Myst Resolve TopicalKetorolac tromethamine (0.3 g/100mL) + Bupivacaine hydrochloride monohydrate (0.3 g/100mL) + Chitosan low molecular weight (20-200 mpa.s) (0.1 g/100mL) + Lidocaine hydrochloride (5 g/100mL)Spray, meteredTopicalPrescription Care Llc2016-06-01Not applicableUs
Chi-Myst Resolve TopicalKetorolac tromethamine (0.09 g/30mL) + Bupivacaine hydrochloride monohydrate (0.09 g/30mL) + Chitosan low molecular weight (20-200 mpa.s) (0.03 g/30mL) + Lidocaine hydrochloride (50 g/30mL)Spray, meteredTopicalPrescription Care Llc2016-06-01Not applicableUs
Chi-Myst Synergy TopicalKetorolac tromethamine (0.45 g/30mL) + Bupivacaine hydrochloride monohydrate (0.09 g/30mL) + Chitosan low molecular weight (20-200 mpa.s) (0.03 g/30mL) + Lidocaine hydrochloride (1.5 g/30mL)Spray, meteredTopicalPrescription Care Llc2016-06-01Not applicableUs
Chi-Myst Synergy TopicalKetorolac tromethamine (1.5 g/100mL) + Bupivacaine hydrochloride monohydrate (0.3 g/100mL) + Chitosan low molecular weight (20-200 mpa.s) (0.1 g/100mL) + Lidocaine hydrochloride (5 g/100mL)Spray, meteredTopicalPrescription Care Llc2016-06-01Not applicableUs
Chi-Myst TopicalKetorolac tromethamine (0.3 g/100mL) + Bupivacaine hydrochloride monohydrate (0.3 g/100mL) + Chitosan low molecular weight (20-200 mpa.s) (0.1 g/100mL)Spray, meteredTopicalPrescription Care Llc2016-08-19Not applicableUs
Chi-Myst TopicalKetorolac tromethamine (0.09 g/30mL) + Bupivacaine hydrochloride monohydrate (0.09 g/30mL) + Chitosan low molecular weight (20-200 mpa.s) (0.03 g/30mL)Spray, meteredTopicalPrescription Care Llc2016-08-19Not applicableUs
Dex-Moxi-KetorKetorolac tromethamine (0.4 mg/1mL) + Dexamethasone sodium phosphate (1 mg/1mL) + Moxifloxacin hydrochloride monohydrate (0.5 mg/1mL)Injection, solutionOphthalmicImprimis Njof, Llc2018-01-05Not applicableUs
DexMoxiKetor PFKetorolac tromethamine (0.4 mg/1mL) + Dexamethasone sodium phosphate (1 mg/1mL) + Moxifloxacin hydrochloride monohydrate (0.5 mg/1mL)Injection, solutionIntraocularImprimisRx NJ2018-01-01Not applicableUs
Ketorocaine L KitKetorolac tromethamine (30 mg/1mL) + Isopropyl Alcohol (70 mL/100mL) + Lidocaine hydrochloride (10 mg/1mL) + Povidone-iodine (10 mg/1mL)KitInfiltration; Intramuscular; Intravenous; TopicalAsclemed Usa, Inc.2014-08-15Not applicableUs
Ketorocaine LM KitKetorolac tromethamine (30 mg/1mL) + Bupivacaine hydrochloride monohydrate (2.5 mg/1mL) + Isopropyl Alcohol (70 mL/100mL) + Lidocaine hydrochloride (10 mg/1mL) + Povidone-iodine (10 mg/1mL)KitEpidural; Infiltration; Intramuscular; Intravenous; TopicalAsclemed Usa, Inc.2014-08-11Not applicableUs
International/Other Brands
Bedoral (Be-Tabs Pharmaceuticals) / Dolten (Pfizer) / Dolten SL (Pfizer) / Dorixina forte NF (Roemmers) / Emodol (Jayson) / Etorac (Incepta) / Ketonic (Eskayef) / Ketora (Medicon) / Lixidol (Roche) / Syndol (Roche) / Taradyl (Roche) / Tarasyn (Roche) / Toradol (Roche)
Categories
UNII
YZI5105V0L
CAS number
74103-06-3
Weight
Average: 255.2686
Monoisotopic: 255.089543287
Chemical Formula
C15H13NO3
InChI Key
OZWKMVRBQXNZKK-UHFFFAOYSA-N
InChI
InChI=1S/C15H13NO3/c17-14(10-4-2-1-3-5-10)13-7-6-12-11(15(18)19)8-9-16(12)13/h1-7,11H,8-9H2,(H,18,19)
IUPAC Name
5-benzoyl-2,3-dihydro-1H-pyrrolizine-1-carboxylic acid
SMILES
OC(=O)C1CCN2C1=CC=C2C(=O)C1=CC=CC=C1

Pharmacology

Indication

For the short-term (~5 days) management of moderately severe acute pain that requires analgesia at the opioid level, usually in a postoperative setting.

Associated Conditions
Pharmacodynamics

Ketorolac, an antiinflammatory agent with analgesic and antipyretic properties, is used to treat osteoarthritis and control acute pain. It is a peripherally acting analgesic. The biological activity of ketorolac tromethamine is associated with the S-form. Ketorolac tromethamine possesses no sedative or anxiolytic properties.

Mechanism of action

Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) chemically related to indomethacin and tolmetin. Ketorolac tromethamine is a racemic mixture of [-]S- and [+]R-enantiomeric forms, with the S-form having analgesic activity. Its antiinflammatory effects are believed to be due to inhibition of both cylooxygenase-1 (COX-1) and cylooxygenase-2 (COX-2) which leads to the inhibition of prostaglandin synthesis leading to decreased formation of precursors of prostaglandins and thromboxanes from arachidonic acid. The resultant reduction in prostaglandin synthesis and activity may be at least partially responsible for many of the adverse, as well as the therapeutic, effects of these medications. Analgesia is probably produced via a peripheral action in which blockade of pain impulse generation results from decreased prostaglandin activity. However, inhibition of the synthesis or actions of other substances that sensitize pain receptors to mechanical or chemical stimulation may also contribute to the analgesic effect. In terms of the ophthalmic applications of ketorolac - ocular administration of ketorolac reduces prostaglandin E2 levels in aqueous humor, secondary to inhibition of prostaglandin biosynthesis.

TargetActionsOrganism
AProstaglandin G/H synthase 2
inhibitor
Human
UProstaglandin G/H synthase 1
inhibitor
Human
Absorption

Rapidly and completely absorbed after oral administration

Volume of distribution
  • 0.26 ± 0.08 L/kg [children 4 to 8 years old]
Protein binding

99%

Metabolism

Primarily hepatic. Less than 50% of a dose is metabolized. The major metabolites are a glucuronide conjugate, which may also be formed in the kidney, and p-hydroxy ketorolac. Neither metabolite has significant analgesic activity.

Route of elimination

The principal route of elimination of ketorolac and its metabolites is renal. Approximately 6% of a dose is excreted in the feces.

Half life

2.5 hours for the S-enantiomer compared with 5 hours for the R-enantiomer

Clearance
  • 0.042 +/- 0.01 L/hr/kg [Pediatric Patients]
  • 0.02 L/h/kg [Normal Subjects IM]
  • 0.03 L/h/kg [Normal Subjects oral]
  • 0.02 L/h/kg [Healthy Elderly Subjects IM]
  • 0.02 L/h/kg [Healthy Elderly Subjects oral]
  • 0.03 L/h/kg [Patients with Hepatic Dysfunction IM]
  • 0.03 L/h/kg [Patients with Hepatic Dysfunction oral]
  • 0.02 L/h/kg [Patients with Renal Impairment IM]
  • 0.02 L/h/kg [Patients with Renal Impairment oral]
  • 0.02 L/h/kg [Renal Dialysis Patients IM]
Toxicity

LD50 = 189 mg/kg (rat, oral).

Affected organisms
  • Humans and other mammals
Pathways
PathwayCategory
Ketorolac Action PathwayDrug action
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteraction
(R)-warfarinThe risk or severity of gastrointestinal bleeding can be increased when Ketorolac is combined with (R)-warfarin.
(S)-WarfarinThe risk or severity of gastrointestinal bleeding can be increased when Ketorolac is combined with (S)-Warfarin.
4-hydroxycoumarinThe risk or severity of gastrointestinal bleeding can be increased when Ketorolac is combined with 4-hydroxycoumarin.
AbacavirKetorolac may decrease the excretion rate of Abacavir which could result in a higher serum level.
AbciximabThe risk or severity of bleeding and hemorrhage can be increased when Ketorolac is combined with Abciximab.
AcarboseKetorolac may decrease the excretion rate of Acarbose which could result in a higher serum level.
AcebutololKetorolac may decrease the antihypertensive activities of Acebutolol.
AceclofenacThe risk or severity of adverse effects can be increased when Ketorolac is combined with Aceclofenac.
AcemetacinThe risk or severity of adverse effects can be increased when Ketorolac is combined with Acemetacin.
AcenocoumarolThe risk or severity of gastrointestinal bleeding can be increased when Ketorolac is combined with Acenocoumarol.
Food Interactions
  • Take with food to reduce GI irritation

References

Synthesis Reference

Peter J. Harrington, Hiralal N. Khatri, George C. Schloemer, "Preparation of ketorolac." U.S. Patent US6323344, issued October, 1989.

US6323344
General References
Not Available
External Links
Human Metabolome Database
HMDB0014608
KEGG Compound
C07062
PubChem Compound
3826
PubChem Substance
46507019
ChemSpider
3694
BindingDB
85511
ChEBI
76223
ChEMBL
CHEMBL469
Therapeutic Targets Database
DAP000618
PharmGKB
PA450150
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
PDRhealth
PDRhealth Drug Page
Wikipedia
Ketorolac
ATC Codes
M01AB15 — KetorolacS01BC05 — Ketorolac
AHFS Codes
  • 52:08.20 — Nonsteroidal Anti-inflammatory Agents
  • 28:08.04.92 — Other Nonsteroidal Antiimflammatory Agents
FDA label
Download (138 KB)
MSDS
Download (76.4 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
0Active Not RecruitingOtherCancer of the Ovary / Fallopian Tube Cancer / Peritoneal Cavity Cancer1
0RecruitingBasic ScienceBlood Pressures1
0RecruitingSupportive CareRenal Stones / Ureteral Stent Placement1
0RecruitingTreatmentPain NOS / Renal Colic1
0RecruitingTreatmentUrologic Diseases1
1CompletedOtherHealthy Volunteers1
1CompletedSupportive CareBalanitis / Paraphimosis / Phimosis / Postoperative pain1
1CompletedTreatmentAllergic Rhinitis (AR)1
1CompletedTreatmentAssess Pharmacokinetics of Ketorolac Tromethamine Intranasal and Assess Effects of a Oxymetazoline Hydrochloride on the PK of Ketorolac Tromethamine / Healthy Volunteers1
1CompletedTreatmentHealthy Volunteers6
1CompletedTreatmentInflammatory Reaction1
1CompletedTreatmentPostoperative pain1
1Not Yet RecruitingBasic ScienceArterial hypoxia / Hypercapnia1
1Not Yet RecruitingTreatmentPolytrauma1
1RecruitingTreatmentEvaluating Pharmacokinetics of Intranasal Ketorolac / Pain NOS1
1TerminatedPreventionPostoperative pain1
1WithdrawnDiagnosticInflammatory Reaction1
1, 2RecruitingTreatmentMigraines1
2Active Not RecruitingSupportive CarePostoperative pain1
2CompletedPreventionIrreversible Pulpitis1
2CompletedPreventionRetinopathy of Prematurity1
2CompletedSupportive CareCesarean Section1
2CompletedTreatmentBunionectomy / Orthopedic Procedures1
2CompletedTreatmentDental Impaction / Pain NOS1
2CompletedTreatmentEye Dryness1
2CompletedTreatmentFailed Mechanical Induction1
2CompletedTreatmentIrreversible Pulpitis1
2CompletedTreatmentMacular Edema (ME) / Proliferative Diabetic Retinopathy (PDR)1
2CompletedTreatmentMacular Edema (ME) / Retinopathy, Diabetic1
2CompletedTreatmentMacular Edema After Cataract Surgery in Patients With Diabetes Mellitus1
2CompletedTreatmentMigraines1
2CompletedTreatmentPostoperative pain3
2Enrolling by InvitationPreventionIrreversible Pulpitis1
2Not Yet RecruitingTreatmentSymptomatic Irreversible Pulpitis1
2RecruitingTreatmentElective Cesarean Delivery / Valve Heart Disease1
2RecruitingTreatmentKidney Diseases / Postoperative pain / Renal Stones / Urinary Lithiasis1
2RecruitingTreatmentOpioid-Related Disorders / Opioids Use / Rib Fractures1
2RecruitingTreatmentPostoperative pain1
2TerminatedBasic ScienceHealthy Volunteers1
2TerminatedTreatmentHip Arthroplasty1
2Unknown StatusTreatmentPostoperative Pain Control in Surgical Neonates1
2WithdrawnTreatmentPain NOS1
2, 3Active Not RecruitingDiagnosticCancer, Breast1
2, 3CompletedPreventionGeneral Surgery1
2, 3CompletedTreatmentConjunctivitis, Viral1
2, 3CompletedTreatmentPain NOS / Surgical Abortion1
2, 3CompletedTreatmentPost-surgical Cystoid Macular Edema (PSCME)1
2, 3RecruitingTreatmentPain, Acute1
3Active Not RecruitingTreatmentCurative Breast Cancer Surgery / Inflammatory Positive/Negative Status / Pre Surgical Incision Administration1
3Active Not RecruitingTreatmentOsteoarthritis (OA) / Pain NOS1
3Active Not RecruitingTreatmentPilon Fracture1
3CompletedSupportive CareMyopes Who Have Undergone PRK1
3CompletedTreatmentCataract Extraction / Inflammatory Reaction / Pain NOS1
3CompletedTreatmentCataracts2
3CompletedTreatmentHeadaches / Intranasal Ketamine1
3CompletedTreatmentPain NOS3
3CompletedTreatmentPostoperative Pain Intensity / Rescue Pain Requirements1
3CompletedTreatmentPostoperative Pain in Infants1
3CompletedTreatmentPostoperative pain5
3Not Yet RecruitingTreatmentPost-Operative Pain / Post-partum Pain1
3RecruitingSupportive CareCalcium Nephrolithiasis1
3RecruitingSupportive CarePreoperative Sedation1
3RecruitingTreatmentAbdominal Pain (AP)1
3RecruitingTreatmentAcute nonspecific tenosynovitis / DeQuervain's Tenosynovitis / Inflammatory Diseases / Lateral Epicondylitis / Trigger Finger1
3RecruitingTreatmentKnee Replacement Surgery / Osteoarthritis (OA) / Pain Management1
3RecruitingTreatmentMigraines1
3RecruitingTreatmentOpioids Use / Shoulder Pain1
3TerminatedTreatmentSurgery, Laparoscopic1
3Unknown StatusTreatmentBack Pain2
3Unknown StatusTreatmentNeoplasms, Breast1
4Active Not RecruitingTreatmentAnaesthesia therapy1
4Active Not RecruitingTreatmentObstetrical analgesia therapy1
4CompletedNot AvailableCataracts1
4CompletedNot AvailableEnd Stage Liver Diseases / Lung Cancers1
4CompletedNot AvailableMacula Thickening1
4CompletedBasic ScienceInflammatory Reaction1
4CompletedBasic ScienceSecondary Hyperalgesia1
4CompletedPreventionCataracts / Inflammatory Reaction1
4CompletedPreventionCesarean Section1
4CompletedPreventionCystoid Macular Edema Following Cataract Surgery, Bilateral1
4CompletedPreventionCystoid Macular Edema, Postoperative / Diabetes Mellitus (DM)1
4CompletedPreventionMacular Edema (ME)1
4CompletedPreventionPain NOS1
4CompletedPreventionThroat Pain1
4CompletedSupportive CareCataracts / Type 2 Diabetes Mellitus1
4CompletedSupportive CarePain NOS2
4CompletedSupportive CarePostoperative pain1
4CompletedTreatmentAcute Pseudophakic Cystoid Macular Edema1
4CompletedTreatmentArthroplasties, Hip Replacement1
4CompletedTreatmentArthroplasty, Knee Replacement / Postoperative pain1
4CompletedTreatmentArthroplasty, Replacement, Hip1
4CompletedTreatmentArthroplasty / Osteoarthritis (OA)1
4CompletedTreatmentArthroscopic Knee Surgery1
4CompletedTreatmentBack Pain Lower Back / Gonarthrosis1
4CompletedTreatmentCarpal Tunnel Release / Distal Radius Fractures / Postoperative pain1
4CompletedTreatmentCataract Extraction1
4CompletedTreatmentCataracts3
4CompletedTreatmentCataracts / Cystoid Macular Edema1
4CompletedTreatmentContraception1
4CompletedTreatmentDry Eye Syndrome (DES) / Ocular Comfort1
4CompletedTreatmentFracture Bone / Pain NOS1
4CompletedTreatmentFracture, Ankle / Trauma Injury1
4CompletedTreatmentGall Stone Disease1
4CompletedTreatmentGlaucoma1
4CompletedTreatmentHeadaches1
4CompletedTreatmentHernia1
4CompletedTreatmentHypermetropia / Myopia1
4CompletedTreatmentInterstitial Cystitis1
4CompletedTreatmentKnee Injuries1
4CompletedTreatmentKnee Osteoarthritis (Knee OA)2
4CompletedTreatmentLaparoscopic Donor Nephrectomy / Nephrectomy1
4CompletedTreatmentMigraine With Aura / Migraine Without Aura / Probable Migraine1
4CompletedTreatmentMigraine, Acute1
4CompletedTreatmentMigraines1
4CompletedTreatmentPain Management Following Cardiopulmonary Bypass Surgery1
4CompletedTreatmentPain NOS4
4CompletedTreatmentPain NOS / Peripheral Nerve Blocks1
4CompletedTreatmentPain NOS / Postoperative pain1
4CompletedTreatmentCaudal epidural block therapy / Pain NOS / Total Knee Arthroplasty (TKA)1
4CompletedTreatmentPain, Acute1
4CompletedTreatmentPost Operative Anterior Chamber Inflammation (Flare)1
4CompletedTreatmentPostoperative pain5
4CompletedTreatmentRenal Stones1
4CompletedTreatmentTotal Hip Arthroplasty (THA)1
4CompletedTreatmentWet Macular Degeneration1
4Enrolling by InvitationOtherCataracts1
4Enrolling by InvitationTreatmentHeadaches1
4Enrolling by InvitationTreatmentKnee Osteoarthritis (Knee OA)1
4Enrolling by InvitationTreatmentNonspecific Pain Post Traumatic Injury1
4Enrolling by InvitationTreatmentOsteoarthritis (OA)1
4Enrolling by InvitationTreatmentPain NOS1
4Enrolling by InvitationTreatmentTotal Hip Arthroplasty (THA)1
4Not Yet RecruitingPreventionPancreatitis1
4Not Yet RecruitingSupportive CareHematoma Postoperative1
4Not Yet RecruitingTreatmentBack Pain Lower Back1
4Not Yet RecruitingTreatmentDiabetes Mellitus (DM) / Rotator Cuff Injury / Rotator Cuff Syndrome / Rotator Cuff Tendinitis1
4Not Yet RecruitingTreatmentGynecology / Surgery, Laparoscopic1
4Not Yet RecruitingTreatmentKnee Replacement, Total1
4Not Yet RecruitingTreatmentPain, Acute1
4Not Yet RecruitingTreatmentPertrochanteric Fracture1
4Not Yet RecruitingTreatmentPostoperative pain1
4Not Yet RecruitingTreatmentRenal Colic1
4RecruitingSupportive CareColon Diverticulosis / Colonic Neoplasms / Constipation Drug Induced / Diverticulitis, Colonic / Ileus / Ileus paralytic / Ileus; Mechanical / Malignant Neoplasm of Colon / Occasional Constipation / Postoperative pain / Rectum Cancer / Rectum Neoplasm1
4RecruitingSupportive CareObstructive Sleep Apnea (OSA)1
4RecruitingTreatmentAcute Pancreatitis (AP)1
4RecruitingTreatmentAnalgesia / Urolithiasis1
4RecruitingTreatmentAnalgesic Adverse Reaction1
4RecruitingTreatmentDeQuervain Tendinopathy1
4RecruitingTreatmentKnee Osteoarthritis (Knee OA)1
4RecruitingTreatmentMigraines1
4RecruitingTreatmentMigrainous Headache1
4RecruitingTreatmentMyofascial Pain Syndrome1
4RecruitingTreatmentOpiate withdrawal symptoms1
4RecruitingTreatmentOtitis Media (OM) / Postoperative pain1
4RecruitingTreatmentPain NOS1
4RecruitingTreatmentRib Fracture Multiple / Rib Fractures1
4RecruitingTreatmentThoracolumbar Spinal Fusions1
4TerminatedSupportive CarePostoperative Pain Management / Urolithiasis1
4TerminatedTreatmentArthroplasty, Replacement, Knee1
4TerminatedTreatmentDegenerative Joint Disease / Osteoarthritis (OA)1
4TerminatedTreatmentHematologic Diseases / Sickle Cell Disorders1
4Unknown StatusPreventionBlindness / Retinal Detachment / Retinopathy of Prematurity1
4Unknown StatusSupportive CareChronic Pelvic Pain1
4Unknown StatusTreatmentCataracts1
4Unknown StatusTreatmentPain NOS1
4Unknown StatusTreatmentPost Vasectomy Pain1
4Unknown StatusTreatmentRenal Colic1
4WithdrawnSupportive CarePain Management / Total Knee Arthroplasty (TKA)1
4WithdrawnTreatmentArthritic Knee Pain1
4WithdrawnTreatmentArthroplasty, Replacement, Knee / Knee Osteoarthritis (Knee OA)1
4WithdrawnTreatmentMalignant Neoplasm of Female Breast1
4WithdrawnTreatmentMigraines1
4WithdrawnTreatmentPostoperative pain1
4WithdrawnTreatmentTotal Knee Arthroplasty (TKA)1
Not AvailableCompletedOtherHealthy Controls1
Not AvailableCompletedPreventionAnesthesia Complication1
Not AvailableCompletedPreventionAnesthesia Intubation Complications / Tracheal Disease1
Not AvailableCompletedPreventionMacular Edema (ME)1
Not AvailableCompletedPreventionMacular Edema, Cystoid1
Not AvailableCompletedPreventionRenal Cell Adenocarcinoma1
Not AvailableCompletedSupportive CarePerforated Appendicitis1
Not AvailableCompletedSupportive CareUreteroneocystostomy1
Not AvailableCompletedTreatmentAcute Renal Colic1
Not AvailableCompletedTreatmentAge-Related Macular Degeneration (ARMD) / Central Retinal Vein Occlusion (CRVO) / Diabetic Macular Edema (DME)1
Not AvailableCompletedTreatmentCataracts2
Not AvailableCompletedTreatmentCongenital Heart Disease (CHD)1
Not AvailableCompletedTreatmentContraception / Inhalation of Nitrous Oxide1
Not AvailableCompletedTreatmentFebrile Morbidity / Pain NOS1
Not AvailableCompletedTreatmentGlaucoma, Primary Open Angle (POAG) / Pseudoexfoliation Syndrome1
Not AvailableCompletedTreatmentGynecologic Diseases1
Not AvailableCompletedTreatmentKnee Osteoarthritis (Knee OA)2
Not AvailableCompletedTreatmentKnee Osteoarthritis (Knee OA) / Pain, Chronic1
Not AvailableCompletedTreatmentMeniscectomy1
Not AvailableCompletedTreatmentOpen Heart Surgery / Postoperative pain1
Not AvailableCompletedTreatmentOther Acute Pain1
Not AvailableCompletedTreatmentPain Control With IUD Insertion1
Not AvailableCompletedTreatmentPain NOS1
Not AvailableCompletedTreatmentPostcesarean Analgesia1
Not AvailableCompletedTreatmentPostoperative pain1
Not AvailableCompletedTreatmentRenal Colic1
Not AvailableCompletedTreatmentRenal Stones1
Not AvailableNot Yet RecruitingTreatmentIrreversible Pulpitis1
Not AvailableNot Yet RecruitingTreatmentLiver Diseases / Neoplasms, Hepatic / Secondary Malignant Neoplasm of Liver1
Not AvailableRecruitingBasic ScienceCancer of the Ovary / Fallopian Tube Cancer / Malignant Peritoneal Neoplasm1
Not AvailableRecruitingSupportive CareInguinal Hernias / Postoperative pain1
Not AvailableRecruitingSupportive CarePostoperative pain / Undescended Testis1
Not AvailableRecruitingTreatmentLumbar Disc Disease / Lumbar Osteoarthritis / Spinal Stenosis / Spondylosis1
Not AvailableRecruitingTreatmentMigrainous Headache1
Not AvailableTerminatedNot AvailableDegeneration / Ectasia / Keratoconus2
Not AvailableTerminatedTreatmentBunions1
Not AvailableTerminatedTreatmentOpen Angle Glaucoma (OAG)1
Not AvailableUnknown StatusNot AvailableRecurrent Acute Tonsillitis1
Not AvailableUnknown StatusTreatmentGlaucoma1
Not AvailableUnknown StatusTreatmentOsteoarthritis (OA)1
Not AvailableUnknown StatusTreatmentPain NOS / Postoperative pain1
Not AvailableWithdrawnTreatmentSubacromial Bursitis / Subacromial Impingement Syndrome1

Pharmacoeconomics

Manufacturers
  • Akorn strides llc
  • Amphastar pharmaceutical inc
  • Apotex inc richmond hill
  • Apothecon inc div bristol myers squibb
  • App pharmaceuticals llc
  • Baxter healthcare corp anesthesia and critical care
  • Baxter healthcare corp anesthesia critical care
  • Bedford laboratories div ben venue laboratories inc
  • Claris lifesciences ltd
  • Gland pharma ltd
  • Hospira inc
  • Luitpold pharmaceuticals inc
  • Sandoz canada inc
  • Sun pharma global inc
  • Wockhardt ltd
  • Roche palo alto llc
  • Allergan inc
  • Allergan
  • Akorn inc
  • Alcon inc
  • Roxro pharma inc
  • Mylan pharmaceuticals inc
  • Pliva inc
  • Roxane laboratories inc
  • Teva pharmaceuticals usa inc
  • Watson laboratories inc
Packagers
  • Akorn Inc.
  • Allergan Inc.
  • Amerisource Health Services Corp.
  • Apotex Inc.
  • Apotheca Inc.
  • Apothecary Shop Wholesale
  • APP Pharmaceuticals
  • A-S Medication Solutions LLC
  • Baxter International Inc.
  • Bedford Labs
  • Ben Venue Laboratories Inc.
  • Bryant Ranch Prepack
  • Cardinal Health
  • Corepharma LLC
  • Cura Pharmaceutical Co. Inc.
  • Direct Dispensing Inc.
  • Dispensing Solutions
  • Diversified Healthcare Services Inc.
  • Ethex Corp.
  • F Hoffmann-La Roche Ltd.
  • Falcon Pharmaceuticals Ltd.
  • General Injectables and Vaccines Inc.
  • H.J. Harkins Co. Inc.
  • Hospira Inc.
  • Innoviant Pharmacy Inc.
  • Kaiser Foundation Hospital
  • Keltman Pharmaceuticals Inc.
  • Lake Erie Medical and Surgical Supply
  • Mckesson Corp.
  • Murfreesboro Pharmaceutical Nursing Supply
  • Mylan
  • Neuman Distributors Inc.
  • Novex Pharma
  • Nucare Pharmaceuticals Inc.
  • Palmetto Pharmaceuticals Inc.
  • PD-Rx Pharmaceuticals Inc.
  • Physicians Total Care Inc.
  • Pliva Inc.
  • Preferred Pharmaceuticals Inc.
  • Prescript Pharmaceuticals
  • Rebel Distributors Corp.
  • Redpharm Drug
  • Resource Optimization and Innovation LLC
  • Southwood Pharmaceuticals
  • Spectrum Pharmaceuticals
  • St Mary's Medical Park Pharmacy
  • Stat Rx Usa
  • Strides Arcolab Limited
  • Sun Pharmaceutical Industries Ltd.
  • Syntex SA
  • Taylor Pharmaceuticals
  • Teva Pharmaceutical Industries Ltd.
  • Wockhardt Ltd.
Dosage forms
FormRouteStrength
SolutionOphthalmic5 mg/1mL
Solution / dropsOphthalmic50 mg/1mL
SolutionOphthalmic0.5 %
SolutionOphthalmic0.4 %
SolutionOphthalmic40 mg/1mL
Solution / dropsOphthalmic5 mg/1mL
Kit
SolutionOphthalmic0.45 %
Spray, meteredTopical
Injection, solutionOphthalmic
Injection, solutionIntraocular
KitInfiltration; Intramuscular; Intravenous; Topical
KitEpidural; Infiltration; Intramuscular; Intravenous; Topical
InjectionIntramuscular30 mg/1mL
InjectionIntramuscular60 mg/2mL
InjectionIntramuscular; Intravenous15 mg/1mL
InjectionIntramuscular; Intravenous30 mg/1mL
InjectionIntramuscular; Intravenous60 mg/1mL
Injection, solutionIntramuscular15 mg/1mL
Injection, solutionIntramuscular30 mg/1mL
Injection, solutionIntramuscular60 mg/2mL
Injection, solutionIntramuscular; Intravenous15 mg/1mL
Injection, solutionIntramuscular; Intravenous30 mg/1mL
Injection, solutionIntramuscular; Intravenous60 mg/2mL
Injection, solutionIntravenous30 mg/1mL
SolutionOphthalmic4 mg/1mL
SolutionOphthalmic5 mg/1
Solution / dropsOphthalmic4 mg/1mL
Solution / dropsOphthalmic4.5 mg/1mL
TabletOral10 mg/1
Tablet, film coatedOral10 mg/1
LiquidIntramuscular30 mg
SolutionIntramuscular30 mg
Solution / dropsOphthalmic
Injection, solution, concentrateIntraocular
KitEpidural; Infiltration; Intramuscular; Intravenous
Spray, meteredNasal15.75 mg/1
SolutionIntramuscular10 mg
LiquidIntramuscular10 mg
TabletOral10 mg
Prices
Unit descriptionCostUnit
Acular 0.5% Solution 10ml Bottle254.39USD bottle
Acular 0.5% Solution 5ml Bottle122.36USD bottle
Ketorolac Tromethamine 0.4% Solution 5ml Bottle109.72USD bottle
Ketorolac tromethamine powder71.05USD g
Acular 0.5% Solution 3ml Bottle59.34USD bottle
Acular ls 0.4% ophth sol24.46USD ml
Acular 0.5% eye drops18.68USD ml
Ketorolac 30 mg/ml syringe8.77USD ml
Ketorolac 15 mg/ml syringe8.39USD ml
Acuvail 0.45% ophth solution4.17USD each
Ketorolac Tromethamine 30 mg/ml3.9USD ml
Acular 0.5 % Solution3.78USD ml
Toradol 10 mg/ml2.52USD ml
Ketorolac im 30 mg/ml syring2.11USD ml
Apo-Ketorolac 0.5 % Solution2.11USD ml
Ratio-Ketorolac 0.5 % Solution2.11USD ml
Toradol 10 mg tablet1.53USD tablet
Ketorolac Tromethamine 10 mg tablet1.06USD tablet
Ketorolac 10 mg tablet0.93USD tablet
Toradol 10 mg Tablet0.76USD tablet
Apo-Ketorolac 10 mg Tablet0.43USD tablet
Novo-Ketorolac 10 mg Tablet0.43USD tablet
Nu-Ketorolac 10 mg Tablet0.43USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US5110493No1992-05-052009-11-05Us
CA1328614No1994-04-192011-04-19Canada
US9216127No2015-12-222024-05-28Us
US8008338Yes2011-08-302027-11-24Us
US8207215Yes2012-06-262024-11-28Us
US8377982Yes2013-02-192024-11-28Us
US8541463Yes2013-09-242024-11-28Us
US8906950No2014-12-092024-05-28Us
US9216167No2015-12-222024-05-28Us
US8946281No2015-02-032024-05-28Us
US8648107No2014-02-112024-05-28Us
US6333044No2001-12-252018-12-25Us
US7842714No2010-11-302029-08-15Us
US9192571No2015-11-242028-03-07Us
US8512717No2013-08-202028-03-07Us
US8992952No2015-03-312024-08-05Us
US8173707Yes2012-05-082024-01-30Us
US9278101Yes2016-03-082024-01-30Us
US8586633Yes2013-11-192024-01-30Us
US9066856Yes2015-06-302034-04-23Us
US9399040Yes2016-07-262024-01-30Us
US9486406Yes2016-11-082034-04-23Us
US9855246No2018-01-022033-10-23Us

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)165-167 °C (tromethamine salt)Not Available
water solubility25 mg/mL (tromethamine salt)Not Available
logP2.1Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.513 mg/mLALOGPS
logP2.66ALOGPS
logP2.28ChemAxon
logS-2.7ALOGPS
pKa (Strongest Acidic)3.84ChemAxon
pKa (Strongest Basic)-7.8ChemAxon
Physiological Charge-1ChemAxon
Hydrogen Acceptor Count3ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area59.3 Å2ChemAxon
Rotatable Bond Count3ChemAxon
Refractivity70.19 m3·mol-1ChemAxon
Polarizability26.67 Å3ChemAxon
Number of Rings3ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.9919
Blood Brain Barrier+0.7918
Caco-2 permeable-0.8957
P-glycoprotein substrateNon-substrate0.7127
P-glycoprotein inhibitor INon-inhibitor0.9624
P-glycoprotein inhibitor IINon-inhibitor0.8684
Renal organic cation transporterNon-inhibitor0.6042
CYP450 2C9 substrateNon-substrate0.7845
CYP450 2D6 substrateNon-substrate0.7046
CYP450 3A4 substrateNon-substrate0.6338
CYP450 1A2 substrateInhibitor0.5483
CYP450 2C9 inhibitorNon-inhibitor0.9081
CYP450 2D6 inhibitorNon-inhibitor0.9333
CYP450 2C19 inhibitorNon-inhibitor0.9225
CYP450 3A4 inhibitorNon-inhibitor0.9621
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9467
Ames testNon AMES toxic0.7615
CarcinogenicityNon-carcinogens0.9592
BiodegradationNot ready biodegradable0.5254
Rat acute toxicity2.5902 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9478
hERG inhibition (predictor II)Non-inhibitor0.9298
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available
LC-MS/MS Spectrum - LC-ESI-QTOF , positiveLC-MS/MSsplash10-0a4i-0190000000-cc495a56f46ce2f38f4c
LC-MS/MS Spectrum - LC-ESI-QTOF , positiveLC-MS/MSsplash10-0a4i-0900000000-49260d5fd66684718972
LC-MS/MS Spectrum - LC-ESI-QTOF , positiveLC-MS/MSsplash10-0a4i-3900000000-cf3a2eedecd98f879db6
LC-MS/MS Spectrum - LC-ESI-QTOF , positiveLC-MS/MSsplash10-056r-9500000000-a993ea029f81823db36e
LC-MS/MS Spectrum - LC-ESI-QTOF , positiveLC-MS/MSsplash10-004i-9200000000-238f6cde2fac6b0ba421
MS/MS Spectrum - , positiveLC-MS/MSsplash10-0a4i-1590000000-070501bbf446e4fc9fea

Taxonomy

Description
This compound belongs to the class of organic compounds known as aryl-phenylketones. These are aromatic compounds containing a ketone substituted by one aryl group, and a phenyl group.
Kingdom
Organic compounds
Super Class
Organic oxygen compounds
Class
Organooxygen compounds
Sub Class
Carbonyl compounds
Direct Parent
Aryl-phenylketones
Alternative Parents
Pyrrolizines / Benzoyl derivatives / Substituted pyrroles / Heteroaromatic compounds / Monocarboxylic acids and derivatives / Carboxylic acids / Azacyclic compounds / Organopnictogen compounds / Organonitrogen compounds / Organic oxides
show 1 more
Substituents
Aryl-phenylketone / Benzoyl / Pyrrolizine / Monocyclic benzene moiety / Substituted pyrrole / Benzenoid / Pyrrole / Heteroaromatic compound / Monocarboxylic acid or derivatives / Carboxylic acid
show 9 more
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
monocarboxylic acid, aromatic ketone, amino acid, pyrrolizines (CHEBI:76223)

Targets

Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Inhibitor
General Function
Prostaglandin-endoperoxide synthase activity
Specific Function
Converts arachidonate to prostaglandin H2 (PGH2), a committed step in prostanoid synthesis. Constitutively expressed in some tissues in physiological conditions, such as the endothelium, kidney and...
Gene Name
PTGS2
Uniprot ID
P35354
Uniprot Name
Prostaglandin G/H synthase 2
Molecular Weight
68995.625 Da
References
  1. Hocherl K, Kammerl MC, Schumacher K, Endemann D, Grobecker HF, Kurtz A: Role of prostanoids in regulation of the renin-angiotensin-aldosterone system by salt intake. Am J Physiol Renal Physiol. 2002 Aug;283(2):F294-301. [PubMed:12110513]
  2. Blais V, Zhang J, Rivest S: In altering the release of glucocorticoids, ketorolac exacerbates the effects of systemic immune stimuli on expression of proinflammatory genes in the brain. Endocrinology. 2002 Dec;143(12):4820-7. [PubMed:12446609]
  3. Ma W, Eisenach JC: Intraplantar injection of a cyclooxygenase inhibitor ketorolac reduces immunoreactivities of substance P, calcitonin gene-related peptide, and dynorphin in the dorsal horn of rats with nerve injury or inflammation. Neuroscience. 2003;121(3):681-90. [PubMed:14568028]
  4. Ma W, Eisenach JC: Cyclooxygenase 2 in infiltrating inflammatory cells in injured nerve is universally up-regulated following various types of peripheral nerve injury. Neuroscience. 2003;121(3):691-704. [PubMed:14568029]
  5. Padi SS, Jain NK, Singh S, Kulkarni SK: Pharmacological profile of parecoxib: a novel, potent injectable selective cyclooxygenase-2 inhibitor. Eur J Pharmacol. 2004 Apr 26;491(1):69-76. [PubMed:15102535]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Prostaglandin-endoperoxide synthase activity
Specific Function
Converts arachidonate to prostaglandin H2 (PGH2), a committed step in prostanoid synthesis. Involved in the constitutive production of prostanoids in particular in the stomach and platelets. In gas...
Gene Name
PTGS1
Uniprot ID
P23219
Uniprot Name
Prostaglandin G/H synthase 1
Molecular Weight
68685.82 Da
References
  1. Bosch-Marce M, Claria J, Titos E, Masferrer JL, Altuna R, Poo JL, Jimenez W, Arroyo V, Rivera F, Rodes J: Selective inhibition of cyclooxygenase 2 spares renal function and prostaglandin synthesis in cirrhotic rats with ascites. Gastroenterology. 1999 May;116(5):1167-75. [PubMed:10220509]
  2. Lashbrook JM, Ossipov MH, Hunter JC, Raffa RB, Tallarida RJ, Porreca F: Synergistic antiallodynic effects of spinal morphine with ketorolac and selective COX1- and COX2-inhibitors in nerve-injured rats. Pain. 1999 Jul;82(1):65-72. [PubMed:10422661]
  3. Dionne RA, Khan AA, Gordon SM: Analgesia and COX-2 inhibition. Clin Exp Rheumatol. 2001 Nov-Dec;19(6 Suppl 25):S63-70. [PubMed:11695255]
  4. Uzan A: The unexpected side effects of new nonsteroidal anti-inflammatory drugs. Expert Opin Emerg Drugs. 2005 Nov;10(4):687-8. [PubMed:16262557]
  5. Blais V, Turrin NP, Rivest S: Cyclooxygenase 2 (COX-2) inhibition increases the inflammatory response in the brain during systemic immune stimuli. J Neurochem. 2005 Dec;95(6):1563-74. Epub 2005 Nov 8. [PubMed:16277613]

Drug created on June 13, 2005 07:24 / Updated on November 17, 2018 07:09