Ketorolac Ophthalmic

Ketorolac Ophthalmic is a prescription medication used for the treatment of Allergic Conjunctivitis, Pain, Inflammation, Burning, and Stinging of the Eye after surgery or as caused by seasonal allergies. 

• Ketorolac Ophthalmic is available under the following different brand names: Acular, Acular LS, Acuvail

Adult and pediatric dosage

Ophthalmic solution

• 0.4 % (Ocular LS)
• 0.45 % (Acuvail)
• 0.5 % (Acular)

Allergic Conjunctivitis

Adult dosage

• Acular: Instill 1 drop in the affected eye(s) every 6 hours

Pediatric dosage

• Children below 2 years: Safety and efficacy not established
• Children above 2 years: Instill 1 drop in affected eye(s) every 6 hours (Acular)

Ocular Pain & Inflammation

Adult dosage

• Acuvail: Instill 1 drop to the affected eye(s) twice daily beginning 1 day before surgery and on the day of surgery and continue through the first 2 weeks postoperatively
• Acular: Instill 1 in the affected eye(s) four times daily starting 24 hours after surgery and continuing up to 4 days after surgery

Pediatric dosage

• Children below 2 years: Safety and efficacy not established
• Children above 2 years: Instill 1 drop (Acular) in the affected eye(s) every 6 hours starting 24 hours after surgery and continue through the first 2 weeks postoperatively

Ocular Pain & Burning/Stinging

Adult dosage

• Acular LS: Instill 1 drop in the operated eye or as needed for up to 4 days postoperatively

Pediatric dosage

• Children 2 years: Safety and efficacy not established
• Children above 2 years: Instill 1 drop (Acular LS) in the operated eye or as needed for up to 4 days postoperatively

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Ketorolac Ophthalmic include:

• mild eye pain, stinging, or redness,
• blurred vision,
• watery eyes,
• swollen or puffy eyelids, and
• headache

Serious side effects of Ketorolac Ophthalmic include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• severe burning, stinging, or itching of eyes,
• a wound that will not heal,
• eye pain,
• redness of the eye,
• watering of the eye,
• vision changes,
• increased sensitivity to light,
• white patches on the eyes, and
• crusting or drainage from the eyes

Rare side effects of Ketorolac Ophthalmic include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in your chest; shortness of breath; sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Ketorolac Ophthalmic has no noted severe interactions with any other drugs.
• Ketorolac Ophthalmic has no noted serious interactions with any other drugs.
• Ketorolac Ophthalmic has no noted moderate interactions with any other drugs.
• Ketorolac Ophthalmic has no noted minor interactions with any other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to ASA, NSAIDs, or ingredients in the formulation 

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Ketorolac Ophthalmic?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Ketorolac Ophthalmic?”

Cautions

• Ocular infection possible following surgery: patients should use two bottles and should not use the same bottle for both eyes
• Safety and efficacy of Acular LS not established in post-cataract surgery patients
• NSAIDs may delay healing; concomitant use of topical NSAIDs and topical steroids may increase the potential for healing problems
• Cross-sensitivity or hypersensitivity may occur between other NSAIDs, acetylsalicylic acid, and phenylacetic acid derivatives; bronchospasm or exacerbation of asthma associated with use in patients who have either a known hypersensitivity to aspirin/non-steroidal anti-inflammatory drugs or a past medical history of asthma; caution when treating individuals who have previously exhibited sensitivities to these drugs
• Increased bleeding time due to interference with thrombocyte aggregation; reports that ocularly applied NSAIDs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery; Ophthalmic solution be used with caution in patients with known bleeding tendencies or receiving other medications, which may prolong bleeding time
• Do not administer while wearing contact lenses
• Do not allow the tip of the bottle to contact the eye or surrounding structures because this could cause the tip to become contaminated by common bacteria known to cause ocular infections; serious damage to the eye and subsequent loss of vision may result from using contaminated solutions
• Corneal effects
  • May cause keratitis, and in some susceptible patients, chronic use may cause an epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration, or corneal perforation; these events may be sight-threatening; patients with evidence of corneal epithelial breakdown should immediately discontinue use of topical NSAIDs and be closely monitored for corneal health
  • Post-marketing experience with topical NSAIDs suggests that patients with complicated ocular surgeries, corneal denervation, corneal epithelial defects, diabetes mellitus, ocular surface diseases (.g, dry eye syndrome), rheumatoid arthritis, or repeat ocular surgeries within a short period may be at increased risk for corneal adverse events which may become sight-threatening; topical NSAIDs should be used with caution in these patients
  • Post-marketing experience with topical NSAIDs suggests that use more than 1 day before surgery or use beyond 14 days post-surgery may increase patient risk for occurrence and severity of corneal adverse events

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy.
• Lactation
  • Unknown; use with caution