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AHFS Consumer Medication Information [Internet]. Bethesda (MD): American Society of Health-System Pharmacists; 2000-2011.

AHFS Consumer Medication Information.

Ketorolac Ophthalmic(kee toe role' ak)

Last Revision: March 16, 2011.

Why is this medication prescribed?

Ophthalmic ketorolac is used to treat itchy eyes caused by allergies. It also is used to treat swelling and redness (inflammation) that can occur after cataract surgery. Ketorolac is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the release of substances that cause allergy symptoms and inflammation.

How should this medicine be used?

Ophthalmic ketorolac comes as a solution (liquid) to instill in the eyes. For allergy symptoms, one drop is usually instilled in the affected eyes four times a day. For inflammation after cataract surgery, one drop is usually instilled in the affected eye four times a day for 2 weeks beginning 24 hours after surgery. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ketorolac ophthalmic exactly as directed. Do not use more or less of it or use it more than prescribed by your doctor.

Your allergy symptom (itchy eyes) should improve when you instill the eye drops. If your symptoms do not improve or if they worsen, call your doctor.

For treatment of itchy eyes caused by allergies, continue to use ketorolac eye drops until you are no longer exposed to the substance that causes your symptom, allergy season is over, or your doctor tells you to stop using it.

To instill the eye drops, follow these steps:

  1. Wash your hands thoroughly with soap and water.

  2. Check the dropper tip to make sure that it is not chipped or cracked.

  3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.

  4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.

  5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.

  6. Brace the remaining fingers of that hand against your face.

  7. While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.

  8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.

  9. Place a finger on the tear duct and apply gentle pressure.

  10. Wipe any excess liquid from your face with a tissue.

  11. If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.

  12. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.

  13. Wash your hands to remove any medication.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before using ketorolac eye drops,

  • tell your doctor or pharmacist if you are allergic to ketorolac, aspirin, or any other medications.

  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin; nonsteroidal anti-inflammatory agents, such as celecoxib (Celebrex), diclofenac (Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ibuprofen (Advil, Motrin, Midol), indomethacin (Indocin), ketoprofen (Orudis, Oruvail), ketorolac (Toradol), meclofenamate, mefenamic (Ponstel), nabumetone (Relafen), naproxen (Aleve, Naprosyn), oxaprozin (Daypro), Piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin).

  • tell your doctor if you have or have ever had heart, kidney, or liver disease or bleeding problems.

  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.

  • tell your doctor if you wear soft contact lenses. You should not use ketorolac eye drops while wearing your soft contact lenses.

  • use caution when driving or operating machinery because your vision may be blurred after you instill the drops.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

Instill the missed dose as soon as you remember it. However, if is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not instill a double dose to make up for a missed one.

What side effects can this medication cause?

Ketorolac eye drops may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • stinging and burning of the eyes

  • blurry vision

Some side effects can be serious. If you experience any of the following symptoms, stop using ketorolac eye drops and call your doctor immediately:

  • redness or swelling of eyes, lips, tongue, or skin

  • infection in or around the eye

  • skin rash, hives, or skin changes

  • difficulty breathing or swallowing

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

If someone swallows ketorolac eye drops, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS® Consumer Medication Information. © Copyright, 2011. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

The following brand names are from RxNorm, a standardized nomenclature for clinical drugs produced by the National Library of Medicine:

Brand names

  • Acular

  • Acuvail

What works?

  • Non‐steroidal anti‐inflammatory drugs for treating fluid accumulation in the macula after cataract surgery Non‐steroidal anti‐inflammatory drugs for treating fluid accumulation in the macula after cataract surgery
    Cystoid macular oedema (CMO) is the accumulation of fluid in the macula (central retina) due to leakage from capillaries. Clinically significant CMO following cataract surgery is a complication of unknown cause. Acute CMO, defined as oedema of less than four months duration, often gets better spontaneously. This review included seven randomised controlled trials with a total of 266 participants. Four trials studied the effects of non‐steroidal anti‐inflammatory agents (NSAIDs) in chronic CMO while the other three examined the effect of NSAIDs in acute CMO. This review found two trials which showed that topical NSAID (0.5% ketorolac tromethamine ophthalmic solution) has a positive effect on chronic CMO and a third trial which was supportive of this finding (albeit not statistically significantly so). One study suggested no effect and our review suggests further work is needed for a more conclusive decision regarding use of NSAIDS in chronic CMO. Similarly, the effects of NSAIDs in acute CMO remain unclear and this too needs further investigation.
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