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Details

Stereochemistry RACEMIC
Molecular Formula C15H13NO3
Molecular Weight 255.2686
Optical Activity ( + / - )
Defined Stereocenters 0 / 1
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of KETOROLAC

SMILES

OC(=O)C1CCN2C1=CC=C2C(=O)C3=CC=CC=C3

InChI

InChIKey=OZWKMVRBQXNZKK-UHFFFAOYSA-N
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)

HIDE SMILES / InChI
Ketorolac is a pyrrolizine carboxylic acid derivative structurally related to indomethacin. It is an NSAID and is used principally for its analgesic activity and has been shown to decrease opioid requirements in post-operative patients. It does not affect consciousness or respiration but does have effects on gastric mucosa, renal perfusion, and platelet function. Ketorolac tromethamine ophthalmic solution is sold under brand name acular LS and is indicated for the reduction of ocular pain and burning/stinging following corneal refractive surgery. 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 medication. Analgesia is probably produced via a peripheral action in which blockade of pain impulse generation results from decreased prostaglandin activity.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
ACULAR LS

Approved Use

ACULAR LS ophthalmic solution is indicated for the reduction of ocular pain and burning/stinging following corneal refractive surgery.

Launch Date

2003
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
2382.2 ng/mL
30 mg single, intramuscular
dose: 30 mg
route of administration: Intramuscular
experiment type: SINGLE
co-administered:
KETOROLAC plasma
Homo sapiens
population: UNHEALTHY
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
1805.8 ng/mL
31.5 mg single, nasal
dose: 31.5 mg
route of administration: Nasal
experiment type: SINGLE
co-administered:
KETOROLAC plasma
Homo sapiens
population: HEALTHY
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
11152.8 ng × h/mL
30 mg single, intramuscular
dose: 30 mg
route of administration: Intramuscular
experiment type: SINGLE
co-administered:
KETOROLAC plasma
Homo sapiens
population: UNHEALTHY
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
7477.3 ng × h/mL
31.5 mg single, nasal
dose: 31.5 mg
route of administration: Nasal
experiment type: SINGLE
co-administered:
KETOROLAC plasma
Homo sapiens
population: HEALTHY
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
4.8 h
30 mg single, intramuscular
dose: 30 mg
route of administration: Intramuscular
experiment type: SINGLE
co-administered:
KETOROLAC plasma
Homo sapiens
population: UNHEALTHY
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
5.24 h
31.5 mg single, nasal
dose: 31.5 mg
route of administration: Nasal
experiment type: SINGLE
co-administered:
KETOROLAC plasma
Homo sapiens
population: HEALTHY
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
2 mg single, intrathecal
Highest studied dose
Dose: 2 mg
Route: intrathecal
Route: single
Dose: 2 mg
Sources:
healthy, 18-50
Health Status: healthy
Age Group: 18-50
Sex: M+F
Sources:
30 mg single, intramuscular
Highest studied dose
Dose: 30 mg
Route: intramuscular
Route: single
Dose: 30 mg
Sources:
healthy, 19-45
Health Status: healthy
Age Group: 19-45
Sex: M+F
Sources:
30 mg single, intranasal
Highest studied dose
Dose: 30 mg
Route: intranasal
Route: single
Dose: 30 mg
Sources:
healthy, 19-45
Health Status: healthy
Age Group: 19-45
Sex: M+F
Sources:
31.5 mg 3 times / day multiple, intranasal
Recommended
Dose: 31.5 mg, 3 times / day
Route: intranasal
Route: multiple
Dose: 31.5 mg, 3 times / day
Sources:
unhealthy, 51.7
Health Status: unhealthy
Age Group: 51.7
Sex: M+F
Sources:
Other AEs: Nausea, Constipation...
Other AEs:
Nausea (58%)
Constipation (29%)
Vomiting (28%)
Nasal passage irritation (24%)
Headache (24%)
Flatulence (23%)
Anemia (19%)
Tachycardia (14%)
Pruritis (11%)
Dizziness (6%)
Sources:
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Other AEs: Anaemia, Thrombocytopenia...
Other AEs:
Anaemia (below serious, 7 patients)
Thrombocytopenia (below serious, 3 patients)
Hyponatraemia (below serious, 3 patients)
Hypokalaemia (below serious, 2 patients)
Leucopenia (below serious, 1 patient)
Sources:
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Other AEs: Hypercapnia, Thrombocytopenia...
Other AEs:
Hypercapnia (below serious, 12 patients)
Thrombocytopenia (below serious, 12 patients)
Leukocytosis (below serious, 38 patients)
Hypokalaemia (below serious, 20 patients)
Hyperkalaemia (below serious, 3 patients)
Hyponatraemia (below serious, 10 patients)
Sources:
AEs

AEs

AESignificanceDosePopulation
Pruritis 11%
31.5 mg 3 times / day multiple, intranasal
Recommended
Dose: 31.5 mg, 3 times / day
Route: intranasal
Route: multiple
Dose: 31.5 mg, 3 times / day
Sources:
unhealthy, 51.7
Health Status: unhealthy
Age Group: 51.7
Sex: M+F
Sources:
Tachycardia 14%
31.5 mg 3 times / day multiple, intranasal
Recommended
Dose: 31.5 mg, 3 times / day
Route: intranasal
Route: multiple
Dose: 31.5 mg, 3 times / day
Sources:
unhealthy, 51.7
Health Status: unhealthy
Age Group: 51.7
Sex: M+F
Sources:
Anemia 19%
31.5 mg 3 times / day multiple, intranasal
Recommended
Dose: 31.5 mg, 3 times / day
Route: intranasal
Route: multiple
Dose: 31.5 mg, 3 times / day
Sources:
unhealthy, 51.7
Health Status: unhealthy
Age Group: 51.7
Sex: M+F
Sources:
Flatulence 23%
31.5 mg 3 times / day multiple, intranasal
Recommended
Dose: 31.5 mg, 3 times / day
Route: intranasal
Route: multiple
Dose: 31.5 mg, 3 times / day
Sources:
unhealthy, 51.7
Health Status: unhealthy
Age Group: 51.7
Sex: M+F
Sources:
Headache 24%
31.5 mg 3 times / day multiple, intranasal
Recommended
Dose: 31.5 mg, 3 times / day
Route: intranasal
Route: multiple
Dose: 31.5 mg, 3 times / day
Sources:
unhealthy, 51.7
Health Status: unhealthy
Age Group: 51.7
Sex: M+F
Sources:
Nasal passage irritation 24%
31.5 mg 3 times / day multiple, intranasal
Recommended
Dose: 31.5 mg, 3 times / day
Route: intranasal
Route: multiple
Dose: 31.5 mg, 3 times / day
Sources:
unhealthy, 51.7
Health Status: unhealthy
Age Group: 51.7
Sex: M+F
Sources:
Vomiting 28%
31.5 mg 3 times / day multiple, intranasal
Recommended
Dose: 31.5 mg, 3 times / day
Route: intranasal
Route: multiple
Dose: 31.5 mg, 3 times / day
Sources:
unhealthy, 51.7
Health Status: unhealthy
Age Group: 51.7
Sex: M+F
Sources:
Constipation 29%
31.5 mg 3 times / day multiple, intranasal
Recommended
Dose: 31.5 mg, 3 times / day
Route: intranasal
Route: multiple
Dose: 31.5 mg, 3 times / day
Sources:
unhealthy, 51.7
Health Status: unhealthy
Age Group: 51.7
Sex: M+F
Sources:
Nausea 58%
31.5 mg 3 times / day multiple, intranasal
Recommended
Dose: 31.5 mg, 3 times / day
Route: intranasal
Route: multiple
Dose: 31.5 mg, 3 times / day
Sources:
unhealthy, 51.7
Health Status: unhealthy
Age Group: 51.7
Sex: M+F
Sources:
Dizziness 6%
31.5 mg 3 times / day multiple, intranasal
Recommended
Dose: 31.5 mg, 3 times / day
Route: intranasal
Route: multiple
Dose: 31.5 mg, 3 times / day
Sources:
unhealthy, 51.7
Health Status: unhealthy
Age Group: 51.7
Sex: M+F
Sources:
Leucopenia below serious, 1 patient
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Hypokalaemia below serious, 2 patients
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Hyponatraemia below serious, 3 patients
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Thrombocytopenia below serious, 3 patients
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Anaemia below serious, 7 patients
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Hyponatraemia below serious, 10 patients
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Hypercapnia below serious, 12 patients
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Thrombocytopenia below serious, 12 patients
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Hypokalaemia below serious, 20 patients
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Hyperkalaemia below serious, 3 patients
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Leukocytosis below serious, 38 patients
90 mg single, intravenous
Dose: 90 mg
Route: intravenous
Route: single
Dose: 90 mg
Sources:
unhealthy
Health Status: unhealthy
Sources:
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG

OverviewOther

Other InhibitorOther SubstrateOther Inducer




Drug as perpetrator​
PubMed

PubMed

TitleDatePubMed
A functional analysis of EP4 receptor-expressing neurons in mediating the action of prostaglandin E2 within specific nuclei of the brain in response to circulating interleukin-1beta.
2000 May
Ketorolac entrapped in polymeric micelles: preparation, characterisation and ocular anti-inflammatory studies.
2000 Nov 19
Single-dose dipyrone for acute postoperative pain.
2001
Effects of nonsteroidal anti-inflammatory drugs on post-operative renal function in normal adults.
2001
Preemptive analgesic effects of ketorolac in ankle fracture surgery.
2001 Apr
[Control of postoperative pain in heart surgery. Comparison of analgesics].
2001 Apr
New advances in the treatment of sickle cell disease: focus on perioperative significance.
2001 Aug
Participation of the nitric oxide-cyclic GMP-ATP-sensitive K(+) channel pathway in the antinociceptive action of ketorolac.
2001 Aug 24
[Aortic stent: the anesthesiologist's point of view].
2001 Dec
Delayed diffuse lamellar keratitis after laser in situ keratomileusis.
2001 Dec
A prospective study comparing i.m. ketorolac with i.m. meperidine in the treatment of acute biliary colic.
2001 Feb
Using evidence from different sources: an example using paracetamol 1000 mg plus codeine 60 mg.
2001 Jan 10
A double-blind, randomized comparison of intramuscularly and intravenously administered parecoxib sodium versus ketorolac and placebo in a post-oral surgery pain model.
2001 Jul
Headache in the emergency department.
2001 Jun
Propacetamol versus ketorolac for treatment of acute postoperative pain after total hip or knee replacement.
2001 Jun
Methadone in treatment of tenesmus not responding to morphine escalation.
2001 Mar
In vitro based index of topical anti-inflammatory activity to compare a series of NSAIDs.
2001 Mar
Antinociceptive effects of delta-opioid agonists in Rhesus monkeys: effects on chemically induced thermal hypersensitivity.
2001 Mar
Precipitation in Manchester: ketorolac/cyclizine.
2001 May
Determination of ketorolac in human plasma by reversed-phase high-performance liquid chromatography using solid-phase extraction and ultraviolet detection.
2001 May 5
Retrospective analysis of drug-induced urticaria and angioedema: a survey of 2287 patients.
2001 Nov
Pain control after knee arthroplasty: intraarticular versus epidural anesthesia.
2001 Nov
The effect of ketorolac and sevoflurane anesthesia on renal glomerular and tubular function.
2001 Nov
Analgesia and COX-2 inhibition.
2001 Nov-Dec
Nonsteroidal anti-inflammatory drugs for perioperative pain control.
2001 Oct
Can standard open pediatric urological procedures be performed on an outpatient basis?
2001 Sep
Postoperative pain management: morphine versus ketorolac.
2002 Feb
Is the administration of ketorolac associated with preemptive analgesia?
2002 Feb
Preemptive analgesic effect or short delay for inflammation?
2002 Feb
Epidural hematoma after outpatient epidural anesthesia.
2002 Jan
Opioid-free analgesia following total knee arthroplasty--a multimodal approach using continuous lumbar plexus (psoas compartment) block, acetaminophen, and ketorolac.
2002 Jan-Feb
Multimodal analgesia and intravenous nutrition preserves total body protein following major upper gastrointestinal surgery.
2002 Jan-Feb
Early hospital discharge for intravesical ureteroneocystostomy.
2002 Jun
Intra-muscular ketorolac administered as a supplemental analgesic for removal of impacted third molar teeth: a prospective study.
2002 Mar
Parenteral ketorolac and risk of myocardial infarction.
2002 Mar
Morphological and pharmacological evidence for the role of peripheral prostaglandins in the pathogenesis of neuropathic pain.
2002 Mar
Treatment patterns of isolated benign headache in US emergency departments.
2002 Mar
Effect of topical diclofenac and ketorolac on patient discomfort and corneal sensitivity.
2002 Mar-Apr
Comparison of the morphine-sparing effects of diclofenac sodium and ketorolac tromethamine after major orthopedic surgery.
2002 May
The role of spinal neuropeptides and prostaglandins in opioid physical dependence.
2002 May
Role for both spinal cord COX-1 and COX-2 in maintenance of mechanical hypersensitivity following peripheral nerve injury.
2002 May 24
Patents

Sample Use Guides

The recommended dose of ACULAR LS (ketorolac tromethamine ophthalmic solution) is one drop four times a day in the operated eye as needed for pain and burning/stinging for up to 4 days following corneal refractive surgery. Ketorolac tromethamine ophthalmic solution has been safely administered in conjunction with other ophthalmic medications such as antibiotics, beta blockers, carbonic anhydrase inhibitors, cycloplegics, and mydriatics.
Route of Administration: Other
It was discovered, that ketorolac inhibition of stretch-induced ureteral contractility was concentration-dependent between 1 nM and 1 microM. Local administration of ketorolac at these doses may be useful during the management of stones while at the same time limiting the risk for adverse effects. Porcine ureter strips attached to force displacement transducers were suspended in organ tissue baths that contained aerated Krebs buffer. Tissues equilibrated for 1 hour, and a spontaneous contractility rate was established. Tissues were incubated with a concentration-response curve of ketorolac (0.1 nM-10 microM) for 90 minutes and compared with indomethacin (1 muM) and dimethyl sulfoxide (DMSO) 0.1%. Contractility rates were recorded on a polygraph and analyzed for changes over exposure time
Name Type Language
KETOROLAC
INN   MI   VANDF   WHO-DD  
INN  
Official Name English
ketorolac [INN]
Preferred Name English
KETOROLAC [VANDF]
Common Name English
(±)-5-BENZOYL-2,3-DIHYDRO-1H-PYRROLIZINE-1-CARBOXYLIC ACID
Systematic Name English
1H-PYRROLIZINE-1-CARBOXYLIC ACID, 5-BENZOYL-2,3-DIHYDRO, (±)-
Common Name English
Ketorolac [WHO-DD]
Common Name English
KETOROLAC [MI]
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C1323
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
NDF-RT N0000000160
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
WHO-ATC S01FB51
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
NDF-RT N0000175721
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
WHO-ATC S01BC05
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
WHO-ATC M01AB15
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
WHO-VATC QM01AB15
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
NDF-RT N0000175722
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
WHO-VATC QS01BC05
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
LIVERTOX NBK548459
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
NDF-RT N0000175939
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
Code System Code Type Description
CAS
74103-06-3
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
NCI_THESAURUS
C1219
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
RXCUI
35827
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY RxNorm
DRUG BANK
DB00465
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
IUPHAR
6661
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
EPA CompTox
DTXSID8023189
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
MESH
D020910
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
FDA UNII
YZI5105V0L
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
EVMPD
SUB08376MIG
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
PUBCHEM
3826
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
SMS_ID
100000083097
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
DRUG CENTRAL
1529
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
WIKIPEDIA
KETOROLAC
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
INN
5558
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
CHEBI
6129
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
ChEMBL
CHEMBL469
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
LACTMED
Ketorolac
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
DAILYMED
YZI5105V0L
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY
MERCK INDEX
m6623
Created by admin on Mon Mar 31 17:55:30 GMT 2025 , Edited by admin on Mon Mar 31 17:55:30 GMT 2025
PRIMARY Merck Index