Patient Information Leaflet: Information for the user
Read all of this leaflet carefully before you start using this medicine because it contains important information for you.
• Keep this leaflet. You may need to read it again. • If you have any further questions, ask your doctor or nurse. • If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet
1. What
1. What
2. What you need to know before you are given
Severe anaphylactic-like reactions have been observed in patients with a history of allergic reactions (symptoms of asthma, inflammation of the nasal mucosa or skin reactions) to the use of acetylsalicylic acid (e.g. aspirin) or other anti-inflammatory pain-relief drugs (NSAIDs).
Do not use
if you are allergic to ketorolac or any of the other ingredients of this medicine (listed in section 6). in combination with other anti-inflammatory pain relief drugs (NSAIDs) or acetylsalicylic acid if you have or have had any problems with your stomach or gut, like an ulcer or bleeding if you have severe problems with your liver or heart if you have moderate to severe problems with your kidneys, or are at risk for kidney failure due to dehydration if you are pregnant and in the final trimester (have been pregnant for more than six months) during labour or delivery if you are breast-feeding if you have, or have had bleeding in your brain or other bleeding disorders
if you are taking oxpentifylline (a medicine used to improve blood circulation)
. Warnings and precautions Medicines like
Talk to your doctor before you are given
If you experience gastrointestinal bleeding or ulceration, signs of liver disease or other manifestations such as rash, stop the treatment with this medicine.
Severe skin and soft-tissue reactions have been reported in very rare cases when using a NSAID. Stop the treatment with
Allergic or anaphylactoid reactions (anaphylactoid reaction is a severe allergic reaction which causes severe problems breathing or dizziness), have been reported in patients with a history of hypersensitivity to acetylsalicylic acid, other NSAIDs, or ketorolac. However, these reactions may also occur in patients without a history of allergy to these drugs.
Children and adolescents Safety and efficacy in children and adolescents under 16 years of age has not been assessed. Injection of
Elderly If you are elderly you are more likely to suffer problems, especially bleeding and perforation in the digestive tract.
Other medicines and
Tell your doctor if you are using any of the following types of medicines:
Blood-thinning agents (antiplatelet drugs and anti-coagulants; warfarin, heparin and dextrans) Diuretics (water tablets) Beta-blockers (heart medicine) Methotrexate (amongst other things for psoriasis, arthritis, other autoimmune diseases, cancer) Cyclosporine (immunosuppressive drug) Lithium (mood stabiliser) ACE inhibitors/Angiotensin-II_antagonists (heart medicine/for high blood pressure) Oxpentoxifylline (for claudicatio intermittens) Alcohol SSRIs (preparations to treat depression/anxiety) Other NSAIDs such as acetylsalicylic acid (ASA), celecoxib, diclofenac, diflunisal, etodolac, fenoprofen, flurbiprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, meloxicam, nabumetone, naproxen, oxaprozin, piroxicam, rofecoxib, sulindac, tenoxicam, tiaprofenic acid, tolmetin, or valdecoxib (NOT a complete list) Corticosteroids Opioid analgesics Tacrolimus (immunosuppressive drug) Probenecid (a medicine used for treating problems caused by too much uric acid in your body (e.g. gout, gouty arthritis)
Pregnancy, breast-feeding and fertility If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.
As with other drugs containing aspirin or other NSAIDs, you must inform your doctor before using
Ketorolac passes into breast milk and the breast-feeding child may be affected.
Driving and using machines
3. How
4. Possible side effects Like all medicines,
Common (≥1/100 to <1/10) headache, drowsiness, sweating, dizziness, swelling at the injection site (oedema), nausea, dyspepsia (indigestion), abdominal pain, diarrhoea.
Uncommon (≥1/1,000 to <1/100) inflammation of the lining of the stomach (gastritis), gastrointestinal ulceration, bloody stools (melaena), intestinal gas (flatulence), constipation, rectal bleeding, inflammation of the mouth (stomatitis), vomiting, dry mouth, abnormal taste, tingling of the skin, depression, sleeping disorder (insomnia), nervousness, intense feeling of well-being (euphoria), inability to concentrate, abnormal thoughts, elevated liver enzymes (ASAT) abnormal vision, muscle pain, increased frequency of urination, problems passing water (urine retention), small amounts of urine, shortness of breath, asthma, nosebleeds, itching, flushing, rash, blood spots on the skin (purpura), weakness (asthenia), thirst, pale skin,
Rare (≥1/10,000 to <1/1,000) heart failure low amount of platelets, low or high blood pressure, bleeding after surgery, convulsions (seizures), muscle spasm, abnormal dreams, hallucinations, hearing loss, acute kidney failure, flank pain with or without blood in the urine) and/or increased urea in the blood (azotemia), fluid accumulation in lungs (pulmonary oedema), serious allergic reaction (anaphylactic reactions), such as difficulty in breathing (bronchospasm), throat swelling (laryngeal oedema), low blood pressure (hypotension), flushing and rashes severe skin reactions, such as Stevens-Johnsons syndrome, TEN syndrome, redness and peeling of the skin (exfoliative dermatitis), elevated rash exacerbation of colitis (inflammation of the large intestine) and Crohn's disease (chronic intestinal disorder), perforations or gastrointestinal bleeding, seen as vomit not known (cannot be estimated from the available data) slow heartbeat, palpitations, tinnitus, inflammation of the pancreas (pancreatitis), inflammation of the oesophagus (oesophagitis), painful sore inside the stomach (peptic ulcer) , acid reflux (eructation), satiety, inflammation of the kidneys (nephritis/nephrotic syndrome, haemolytic uraemic syndrome (HUS), bruise (haematoma), swelling in the skin (angioedema), fever, reaction at the site of injection, chest pain, anxiety, psychotic reactions (severe alterations of psychic balance), anorexia, low sodium level in blood, high potassium level in blood inflammation of the membranes surrounding your brain (meningitis) , female infertility, inflammation of the liver (hepatitis), liver failure, icterus (yellowish pigmentation of the skin and eyes), Extended bleeding duration, elevated S-urea, elevated creatinine, abnormal liver function values
Reporting of side effects If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V.* By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment
6. Contents of the pack and other information
What
What
Marketing Authorisation Holder MACURE PHARMA ApS, Hejrevej 39, DK-2400 Copenhagen NV- Denmark
Manufacturer S.A.L.F. S.p.A. Laboratorio Farmacologico – Via Marconi, 2 - Cenate Sotto (BG) – Italia
This leaflet was last revised in: