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Ketorolac has a strong analytical action, also has anti-inflammatory and mild antipyretic action
The mechanism of action is associated with non-selective inhibition of the enzyme activity of cyclooxygenase I and 2, mainly in peripheral tissues, resulting in the inhibition of the biosynthesis of prostaglandins – modulators of pain sensitivity, buy primobolan thermoregulation and inflammation.
By the force of the analgesic effect comparable to morphine significantly superior to other NSAIDs.
After oral analgesic effect observed beginning after 1 hour, the maximum effect is achieved after 1-2 h. Pain syndrome of moderate to severe intensity different genesis (including postoperative, oncological diseases, etc.).

Contraindications
Hypersensitivity to ketorolac or other nonsteroidal anti-inflammatory drugs, “acpirinovaya” asthma, bronchospasm. angioneurotic edema, hypovolemia (irrespective The cause). dehydration.
erosive and ulcerative lesions of the gastrointestinal tract in the acute stage, peptic ulcers, anticoagulation (including hemophilia).
Hepatic and / or renal insufficiency (plasma creatinine greater than 50 mg / l).
Hemorrhagic stroke (confirmed or suspected) , bleeding diathesis, concomitant use with other NSAIDs, or a high risk of rebleeding (including after operations), violation of hematopoiesis.
Pregnancy, childbirth and lactation. Children under the age of 16 years (effectiveness and safety have been established). Preparation is not used for anesthesia before and during surgery due to the high risk of bleeding, and for the treatment of chronic pain.

Precautions
asthma; cholecystitis; chronic heart failure; arterial hypertension; impairment of renal function (plasma buy primobolan creatinine below 50 mg / l); cholestasis; active hepatitis; sepsis; systemic lupus erythematosus;advanced age (over 65 years); polyps of the mucous membranes of the nose and nasopharynx.

Dosing and Administration
Ketorolac administered orally once or repeatedly, depending on the severity of pain. A single dose – 10 mg, in re-admission is recommended to take 10 mg to 4 times a day depending on the severity of pain;the maximum daily dose should not exceed 40 mg.
If ingestion rate should not exceed 5 days.

Side effects
often – more than 3%, less frequently -1-3%, rare – less than 1%. From the digestive system: often (especially in elderly patients over 65 years with a history of erosive and ulcerative lesions of the gastrointestinal tract) – gastralgia, diarrhea; less frequently – stomatitis, flatulence, constipation, vomiting, feeling of fullness; rarely – nausea, erosive and ulcerative lesions of the gastrointestinal tract (including perforation and / or bleeding – abdominal pain, cramping or burning sensation in the epigastric region, melena, vomiting, according to the “coffee grounds”, nausea, heartburn, etc. .), cholestatic jaundice, hepatitis, hepatomegaly, acute pancreatitis. from the mochevydelitelnoy system: rarely – acute renal failure, back pain with or without hematuria and / or azotemia, hemolytic uremic syndrome (hemolytic anemia, renal failure, thrombocytopenia, purpura) , frequent urination, increased or decreased amount of urine, nephritis, edema of renal origin. From the sensory organs: rarely: hearing loss, ringing in the ears, visual disturbances (including blurred visual perception). The respiratory system: rarely: bronchospasm or dyspnoea, rhinitis, laryngeal edema (shortness of breath, difficulty breathing). CNS: often – headache, dizziness, drowsiness, rarely -aseptichesky meningitis (fever, severe headache, seizures, muscle stiffness in the neck and / or back) hyperactivity disorder (mood changes, anxiety), hallucinations, depression, psychosis. cardio-vascular system: less often – increased blood pressure, rarely – pulmonary edema, fainting. From the side of hematopoiesis: rarely – anemia, eosinophilia, leukopenia. On the part of the system hemostasis: . rare – bleeding from surgical wounds, nosebleeds, rectal bleeding part of the skin: less often – skin rash (including makulopapulleznuyu rash), purpura, rarely – exfoliative dermatitis (fever with chills or without redness, induration, or peeling skin , swelling and / or tenderness of the tonsils), urticaria, Stevens-Johnson syndrome, Lyell’s syndrome. Local reactions: less often – burning or pain at the injection site. Allergic reactions: rare – anaphylaxis or anaphylactoid reactions (change in skin color, skin rash , hives, itchy skin, tachypnea or dyspnea, edema of the eyelids, periorbital edema, shortness of breath, difficulty breathing, heaviness in the chest, wheezing). Other: often – edema (face, legs, ankles, fingers, feet, weight gain) ; less often – sweating, rarely – swelling of the tongue, fever.

Overdose symptoms: abdominal pain, nausea, vomiting, the occurrence of peptic ulcer or gastric erosive gastritis, renal dysfunction, metabolic acidosis. Treatment: gastric lavage, administration of adsorbents (activated charcoal) and symptomatic therapy (maintenance of vital functions of the body). It is not displayed sufficiently by dialysis.

Interaction with other medicinal products
Concomitant use of ketorolac with aspirin or other nonsteroidal anti-inflammatory drugs, calcium preparations, corticosteroids, ethanol, corticotropin may lead to ulceration of the gastrointestinal tract and the development of gastro-intestinal bleeding.
Co-administration with paracetamol increases the nephrotoxicity with methotrexate – hepato-and nephrotoxicity. Co-administration of ketorolac and methotrexate is only possible when using low doses of the last (to control the concentration of methotrexate in the blood plasma).
Probenecid reduces the plasma clearance and volume of ketorolac distribution, increases buy primobolan its concentration in blood plasma and increases the period of its half-life.
Against the background of ketorolac is possible to reduce the clearance of methotrexate and lithium and increased toxicity of these substances.
Co-administration with indirect anticoagulants, heparin, thrombolytics, antiplatelet, cefoperazone, tsefotetanom and pentoxifylline increases the risk of bleeding.
Reduces the effect of antihypertensive and diuretic drugs (reduced synthesis of prostaglandins in the kidneys).
When combined with opioid analgesics dose the latter may be significantly reduced.
Antacids do not affect the completeness of absorption of the drug. Increased hypoglycemic effect of insulin and oral hypoglycemic agents (requires recalculation of the dose).
Co-administration with sodium valproate causes a disturbance of platelet aggregation. Increasing the concentration of verapamil and nifedipine in blood plasma.
In the appointment of other nephrotoxic drugs (including gold with drugs) increases the risk of nephrotoxicity. Drugs that block tubular secretion, reduce ketorolac clearance and increase its concentration in blood plasma. anabolic steroids online shop

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