Indications

Perilac (Ketorolac Tromethamine) is a non-steroidal anti-inflammatory drug (NSAID) indicated for:

• Short-term pain management: Moderate to severe acute post-operative pain.
• Ocular use (ophthalmic solution): To relieve pain, inflammation, and light sensitivity following ocular surgery, and to decrease eye inflammation caused by seasonal allergies.

Description & Pharmacology

Perilac belongs to the pyrrolo-pyrrole group of NSAIDs. It is a potent analgesic that acts by inhibiting the cyclooxygenase (COX) enzyme system, thereby blocking prostaglandin synthesis. This mechanism provides its analgesic effect, with a minimal anti-inflammatory effect at typical analgesic doses. It is highly protein-bound, metabolized in the liver, and excreted via the kidneys.

Dosage & Administration

• Tablet: 10 mg every 4-6 hours. It should not be used for more than 7 days, and the daily dose should not exceed 40 mg.
• Injection (IV/IM): Used for moderately severe, acute pain. The total combined duration of parenteral and oral treatment should not exceed 5 days.
  • Single-Dose (IM): 60 mg for patients <65 years, 30 mg for patients >65 years, renally impaired, or weighing <50 kg.
  • Single-Dose (IV): 30 mg for patients <65 years, 15 mg for patients >65 years, renally impaired, or weighing <50 kg.
  • Multiple-Dose: 30 mg every 6 hours (maximum 120 mg/day) for patients <65 years. 15 mg every 6 hours (maximum 60 mg/day) for other populations.
• Eye Drops: 1 drop in each eye, 4 times daily.

Interaction

• Other NSAIDs or Aspirin: Increases the risk of side effects.
• Anticoagulants: Enhances their anticoagulant effect.
• ACE Inhibitors: Increases the risk of renal impairment.
• Methotrexate: Enhances its toxicity.
• Beta Blockers: Reduces their antihypertensive effect.

Contraindications

Ketorolac is contraindicated in patients with hypersensitivity to this drug or other NSAIDs, children under 16 years, and as a prophylactic analgesic before surgery.

Side Effects

Common side effects include nausea, vomiting, gastrointestinal bleeding, headache, drowsiness, fatigue, and hypertension. Other reported effects are peptic ulcer, anxiety, and chest pain.

Pregnancy & Lactation

Ketorolac is a US FDA Pregnancy Category C drug. It should be avoided during pregnancy and lactation unless the benefits outweigh the potential risks to the fetus.

Precautions & Warnings

• Use with caution in patients over 65 years of age, or with a history of peptic ulcer, gastrointestinal bleeding, asthma, or liver dysfunction.
• Eye Drops: Discontinue use if corneal epithelial breakdown occurs. Do not administer while wearing contact lenses.

Therapeutic Class

Perilac is a Non-Opioid Analgesic and is also used for Rheumatoid Arthritis.

Storage Conditions

Keep in a dry place, away from light and heat. Keep out of the reach of children.