Ketral Contraindications

Ketorolac tromethamine should not be used: In patients who have previously exhibited allergy to it; in suspected or confirmed cerebrovascular bleeding or haemophilia in other bleeding problems including coagulation or platelet function disorders due to increased risk of bleeding because ketorolac inhibits platelet aggregation and may also cause gastrointestinal ulceration or haemorrhage; in active, recent or history of gastrointestinal bleeding or recent gastrointestinal perforation or active or history of peptic ulceration, ulceration colitis or other ulcerative gastrointestinal disease due to increased risk of gastrointestinal ulceration, perforation and/or haemorrhage; in aspirin induced nasal polyps associated with bronchospasm, or angioedema, anaphylaxis or history of other severe allergic reactions of cross-sensitivity; in severe renal function impairment due to increased risk of renal failure; during pregnancy labour, delivery or lactation; a history of asthma; hypovolaemia or dehydration from any cause.
Ketorolac tromethamine is not an anaesthetic agent and possesses no sedative or anxiolytic properties; therefore it is not recommended as a preoperative medication when these effects are required.
Ketorolac is not recommended in obstetric analgesia.
Carcinogenicity, mutagenicity and impairment of fertility: In animal, Ketorolac was not associated with tumourigenecity or mutagenicity and did not demonstrate teratogenic potential.
Use in pregnancy and lactation: Ketorolac tromethamine is not recommended during pregnancy; labor or delivery. Ketorolac tromethamine is not recommended for treatment of nursing mothers. Secretion of ketorolac in human milk after ingestion of ketorolac tromethamine is limited. The milk to plasma ration of ketorolac concentrations ranged between 0.015 and 0.037.
Use in children: Safety and efficacy in children have not been established. Therefore, it is not recommended for use in children under 16 years.
Use in the elderly: Because ketorolac is cleared somewhat more slowly by the elderly (see Pharmacology under Actions), who are also more sensitive to the renal effects of NSAIDs (see Renal effects under Precautions), extra caution and the lowest effective dose should be when treating the elderly with ketorolac tromethamine.
Drug abuse and physical dependence: Ketorolac is not a narcotic agonist or antagonist. No subjective symptoms or objective signs of drug withdrawal upon abrupt discontinuation of IV or IM dosing. Patients receiving ketorolac tromethamine for 6 months or longer have not developed which are reasonable predictors of opiate analgesic action (hot plate and tail withdrawal test). In vitro, ketorolac dose not bind to opiate receptors.
These demonstrate that ketorolac tromethamine does not have central opiate-like activity.