IN THE UK THE RECOMMENDED INITIAL DOSE BY THE PARENTERAL ROUTE IS 10 MG OF KETOROLAC TROMETAMOL FOLLOWED BY 10 TO 30 MG EVERY 4 TO 6 HOURS AS REQUIRED, ALTHOUGH KETOROLAC MAY BE GIVEN AS OFTEN AS EVERY 2 HOURS IN THE INITIAL POSTOPERATIVE PERIOD IF REQUIRED. THE TOTAL MAXIMUM DAILY DOSE IS 90 MG (60 MG IN THE ELDERLY, PATIENTS WITH MILD RENAL IMPAIRMENT, AND IN THOSE WEIGHING LESS THAN 50 KG). INTRAVENOUS INJECTIONS SHOULD BE GIVEN OVER AT LEAST 15 SECONDS. DURING TRANSFER FROM PARENTERAL TO ORAL THERAPY THE COMBINED DAILY DOSE FOR ALL FORMS OF KETOROLAC TROMETAMOL SHOULD NOT EXCEED 90 MG (60 MG IN THE ELDERLY, PATIENTS WITH MILD RENAL IMPAIRMENT, AND IN THOSE WEIGHING LESS THAN 50 KG) OF WHICH NO MORE THAN 40 MG SHOULD BE GIVEN ORALLY.
REGIMENS IN USE IN THE USA INCLUDE A SINGLE INTRAMUSCULAR DOSE OF 60 MG OR A SINGLE INTRAVENOUS DOSE OF 30 MG, OR A MULTIPLE-DOSE REGIMEN COMPRISING 30 MG EVERY 6 HOURS INTRAMUSCULARLY OR INTRAVENOUSLY, UP TO A MAXIMUM OF 120 MG DAILY. THESE DOSES SHOULD BE HALVED IN THE ELDERLY, THOSE WITH RENAL IMPAIRMENT, AND THOSE WEIGHING LESS THAN 50 KG. CHILDREN AGED BETWEEN 2 TO 16 YEARS MAY BE GIVEN A SINGLE INTRAMUSCULAR DOSE OF 1 MG/KG UP TO A MAXIMUM OF 30 MG OR A SINGLE INTRAVENOUS DOSE OF 0.5 MG/KG UP TO A MAXIMUM OF 15 MG.
THE RECOMMENDED ORAL DOSE IN THE UK IS 10 MG EVERY 4 TO 6 HOURS (EVERY 6 TO 8 HOURS IN THE ELDERLY) TO A MAXIMUM OF 40 MG DAILY FOR A MAXIMUM DURATION OF 7 DAYS.
IN THE USA THE RECOMMENDED ORAL DOSE IS 20 MG (10 MG IN THE ELDERLY, THE RENALLY IMPAIRED, AND THOSE WEIGHING UNDER 50 KG), FOLLOWED BY 10 MG EVERY 4 TO 6 HOURS TO A MAXIMUM OF 40 MG DAILY.
KETOROLAC TROMETAMOL IS USED AS 0.5% EYE DROPS TO RELIEVE OCULAR ITCHING ASSOCIATED WITH SEASONAL ALLERGIC CONJUNCTIVITIS. KETOROLAC TROMETAMOL EYE DROPS 0.5% HAVE ALSO BEEN USED FOR THE TOPICAL TREATMENT OF CYSTOID MACULAR OEDEMA AND FOR THE PREVENTION AND REDUCTION OF INFLAMMATION ASSOCIATED WITH OCULAR SURGERY. IN THE USA, A 0.4% EYE DROP IS ALSO AVAILABLE FOR POSTOPERATIVE OCULAR INFLAMMATION.