Indications for use of Ketanov are:

Pain syndrome of moderate and severe intensity of various origins (including in the postoperative period, with oncological diseases).

  Pharmachologic effect:

Pharmaceutical group: NSAIDs. Pharmaceutical action: Ketorolac has a pronounced analgesic effect, also has anti-inflammatory and moderate antipyretic effects. The mechanism of action is associated with non-selective inhibition of the activity of the enzyme COX-1 and -2, mainly in peripheral tissues, which results in inhibition of the biosynthesis of PG - modulators of pain sensitivity, thermoregulation and inflammation. Ketorolac is a racemic mixture of [-] S- and [+] R-enantiomers, while the analgesic effect is due to the [-] S form. The drug Ketanov does not affect opioid receptors, does not depress respiration, does not cause drug dependence, does not have a sedative and anxiolytic effect. The strength of the analgesic effect is comparable to that of morphine, significantly superior to other NSAIDs. After intramuscular administration and oral administration, the onset of anesthetic action is noted, respectively, after 0.5 and 1 hour, the maximum effect is achieved after 1-2 hours. Pharmacokinetics: After oral administration, Ketanov® is well absorbed in the gastrointestinal tract - Cmax in blood plasma (0.7 -1.1 mcg / ml) is achieved 40 minutes after taking a dose of 10 mg on an empty stomach. Food rich in fats reduces the Cmax of the drug in the blood and delays its achievement by 1 hour. 99% of the drug binds to blood plasma proteins, and with hypoalbuminemia, the amount of free substance in the blood increases. Bioavailability is 80-100%. Absorption with intramuscular injection is complete and fast. After i / m administration of 30 mg of the drug, Cmax is 1.74-3.1 mcg / ml, 60 mg - 3.23-5.77 mcg / ml, Tmax - 15-73 and 30-60 minutes, respectively. The time to reach equilibrium concentration (CSS) with parenteral and oral administration is 24 hours when administered 4 times a day (above the subtherapeutic) and is 0.65–1.13 μg / ml, 30 mg when administered intramuscularly at a dose of 15 mg - 1.29-2.47 μg / ml; after oral administration of 10 mg - 0.39-0.79 μg / ml. The volume of distribution is 0.15-0.33 l / kg. In patients with renal insufficiency, the volume of distribution of the drug may increase by 2 times, and its R-enantiomer - by 20%. Penetrates into breast milk: after the mother takes the first and second doses of ketorolac (10 mg), Cmax in milk is reached after 2 hours and is 7.3 and 7.9 ng / l, respectively. More than 50% of the administered dose is metabolized in the liver with the formation of pharmacologically inactive metabolites. The main metabolites are glucuronides, which are excreted by the kidneys, and p-hydroxyketorolac. It is excreted by 91% - by the kidneys, 6% - through the intestines. T1 / 2 in patients with normal renal function averages 5.3 hours (3.5–9.2 hours after i / m administration of 30 mg and 2.4–9 hours after oral administration of 10 mg). T1 / 2 is lengthened in older patients and shortened in younger patients. Liver function has no effect on T1 / 2. In patients with impaired renal function with a plasma creatinine concentration of 19-50 mg / L (168-442 μmol / L) T1 / 2 is 10.3-10.8 hours, with more severe renal failure - more than 13.6 hours The total clearance is 0.023 l / kg / h (0.019 l / kg / h in elderly patients) when administered intramuscularly at a dose of 30 mg, 0.025 l / kg / h when taken orally at a dose of 10 mg; in renal failure with a concentration of creatinine in the blood plasma of 19-50 mg / l with i / m administration at a dose of 30 mg - 0.015 l / kg / h, with 10 mg taken orally - 0.016 l / kg / h. Not excreted during hemodialysis.