Ketorolac is used orally to treat moderately severe acute pain (e.g., migraine headaches), but should not be used for more than five days. It is also used in the eye to treat itching due to seasonal allergies and to prevent inflammation following cataract surgery.
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Taking ketorolac with a high-fat breakfast slows the speed of drug absorption by about an hour, but it does not affect overall blood levels of the drug.1 To lessen stomach upset, ketorolac tablets should be taken with a meal or a snack.
A 50-year-old male developed high blood levels of potassium following eight days of ketorolac treatment.3 Additional research is needed to determine whether taking ketorolac together with supplemental potassium might enhance this side effect. individuals taking oral ketorolac should probably avoid potassium supplements and salt substitutes until more information is available.
White willow bark (Salix alba) contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs.4 Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.
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1. Mroszczak EJ, Jung D, Yee J, et al. Ketorolac tromethamine pharmacokinetics and metabolism after intravenous, intramuscular, and oral administration in humans and animals. Pharmacotherapy 1990;10:33S–9S.
2. Mroszczak EJ, Jung D, Yee J, et al. Ketorolac tromethamine pharmacokinetics and metabolism after intravenous, intramuscular, and oral administration in humans and animals. Pharmacotherapy 1990;10:33S–9S.
3. Kelley M, Bastani B. Ketorolac-induced acute renal failure and hyperkalemia. Clin Nephrol 1995;44:276–7 [letter].
4. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
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