Patient Medication Information: uses, side effects, how to take - Mar-Ketorolac
Serious Warnings and Precautions
| Heart and blood vessel problems: |
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| Stomach and intestine (gastrointestinal) problems: |
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Talk to your healthcare professional about any medical conditions you have and medicines you are taking. Pregnancy: |
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What is MAR-KETOROLAC used for?
MAR-KETOROLAC is used in adults for the short-term relief of moderate to moderately severe pain. It is usually used:
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How does MAR-KETOROLAC work?
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What are the ingredients in MAR-KETOROLAC?
Medicinal ingredient: ketorolac tromethamine
Non-medicinal ingredients: Hydroxylpropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol and titanium dioxide.
MAR-KETOROLAC comes in the following dosage forms:
Tablets: 10 mg of ketorolac tromethamine.
Do not use MAR-KETOROLAC if:
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To help avoid side effects and ensure proper use, talk to your healthcare professional before you take MAR-KETOROLAC. Talk about any health conditions or problems you may have, including if you:
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Other warnings you should know about:
MAR-KETOROLAC may cause serious side effects, including:
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- MAR-KETOROLAC can cause blood problems, bleeding and prolonged bleeding.
- Taking MAR-KETOROLAC with the following medicines can increase the risk of bleeding:
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See the Serious side effects and what to do about them table for more information on these and other serious side effects.
Infection: MAR-KETOROLAC may mask signs of an infection such as fever or muscle aches. If you notice other symptoms of infection (e.g., painful or frequent urination, sore throat, cough), tell your healthcare professional.
Surgery: Tell all your doctors, dentists, pharmacists and/or healthcare professionals that you are taking this medicine. This is especially important if you are planning to have heart surgery.
Fertility in women: MAR-KETOROLAC may affect your fertility. This means that it may be difficult for you to have a child. If you have trouble having a child, you might need to stop taking MAR-KETOROLAC. Talk to your healthcare professional if you have any questions about this.
Patients 65 years or older: Side effects like gastrointestinal problems may happen more often. Your healthcare professional might have you start with a lower dose of MAR-KETOROLAC. They will monitor your health during and after treatment.
Driving and using machinery: MAR-KETOROLAC may cause eye or nervous system problems. This includes tiredness, trouble sleeping, blurred vision, spinning or dizziness (vertigo), hearing problems or depression. Be careful about driving or doing activities that require you to be alert. If you become drowsy, dizzy or light-headed after taking MAR-KETOROLAC, do NOT drive or operate machinery.
Check-ups and testing: You will have regular visits with your healthcare professional during treatment with MAR-KETOROLAC to monitor your health. They will:
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Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.
The following may also interact with MAR-KETOROLAC:
- antacids, used to treat symptoms of excess stomach acid.
- medicines used to treat depression (antidepressants), like citalopram, fluoxetine, paroxetine, sertraline, and lithium.
- medicines used to treat high blood pressure, like enalapril, lisinopril, perindopril, ramipril, candesartan, irbesartan, losartan, and valsartan.
- medicines used to lower extra fluid levels (diuretics), like furosemide, and hydrochlorothiazide.
- medicines used as blood thinners or to prevent blood clots, like warfarin, clopidogrel, heparin, and dextrans.
- medicines used to treat seizures or epilepsy (antiepileptics), like carbamazepine and phenytoin.
- cyclosporin and tacrolimus, used to lower the risk of organ transplant rejection.
- methotrexate and pemetrexed, used to treat different cancers.
- digoxin, used to treat heart disorders.
- corticosteroids, used to treat inflammation, like glucocorticoids such as prednisone.
- mifepristone, used for abortions. MAR-KETOROLAC should not be taken for 8 to 12 days after taking mifepristone.
- medicines used to treat bacterial infections (antibiotics), like aminoglycosides and quinolone antibiotics.
- opioids, used to relive pain.
- thiothixene, used to treat schizophrenia.
- alprazolam, used to manage symptoms of anxiety.
- zidovudine, used to prevent and treat human immunodeficiency virus HIV.
- medicines used to treat muscle spasms and back pain (muscle relaxants).
alcohol.
Serious Drug Interactions
Do not take MAR-KETOROLAC with:
- acetylsalicylic acid (ASA) or other NSAIDs, used to treat pain, fever and inflammation (e.g., celecoxib, diclofenac, ibuprofen, indomethacin, ketorolac, meloxicam, naproxen);
- pentoxifylline (also known as oxpentifylline), used to improve blood circulation;
- probenecid, used to treat gout.
Taking MAR-KETOROLAC with these medicines may cause serious drug interactions. Ask your healthcare professional if you are unsure you are taking these medicines.
How to take MAR-KETOROLAC:
- Take exactly as your healthcare professional has told you. They should recommend the lowest dose possible for your treatment for the shortest time needed.
- Your healthcare professional will check if MAR-KETOROLAC is working for you and if it is causing you any unwanted effects. They may change your dose depending on how you respond to MAR-KETOROLAC.
To lessen stomach upset, take this medicine immediately after a meal (with food or milk). However, taking MAR-KETOROLAC with food may delay the onset of pain relief. If stomach upset (indigestion, nausea, vomiting, stomach pain or diarrhea) occurs and continues, contact your healthcare professional.
- You should remain standing or sitting upright for about 15 to 30 minutes after taking this medicine. This helps to prevent irritation that may lead to trouble swallowing.
- This medication has been prescribed specifically for you. Do NOT give it to anyone else. It may harm them, even if their symptoms seem to be similar to yours.
Usual dose:
For pain relief after surgery (including dental procedures) or giving birth:
- The usual dose is 10 mg every 4 to 6 hours as needed.
- Maximum duration of treatment: 5 days.
For pain relief for an injury causing muscle or joint pain:
- The usual dose is 10 mg every 4 to 6 hours as needed.
- Maximum duration of treatment: 7 days.
Overdose:
Signs of an overdose with MAR-KETOROLAC may include:
- nausea or vomiting;
- abnormally fast, slow or deep breathing;
- abdominal pain, ulcer or bleeding from the stomach or gut;
- kidney problems;
- high blood pressure;
- coma.
| If you think you, or a person you are caring for, have taken too much MAR-KETOROLAC, contact a healthcare professional, hospital emergency department, regional poison control centre or Health Canada's toll-free number, 1-844 POISON-X (1-844-764-7669) immediately, even if there are no signs or symptoms. |
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Missed Dose:
If you miss a dose, take it as soon as you remember. Take your next dose at the usual time. Do not take two doses at the same time to make up for a forgotten dose.
What are possible side effects from using MAR-KETOROLAC?
These are not all the possible side effects you may have when taking MAR-KETOROLAC. If you experience any side effects not listed here, tell your healthcare professional.
Side effects may include:
- Nausea, vomiting, diarrhea, constipation, stomach upset, heartburn, indigestion, feeling gassy;
- Headache, dizziness, light-headedness;
- Feeling tired, trouble sleeping, abnormal dreams;
- Feeling of burning or prickling of the skin;
- Anxiety, nervousness;
- Thirst, dry mouth, sore throat, changes in tastes;
- Bruises, rash;
- Muscle pain/twitching/weakness;
- Mouth sores;
- Increased sweating;
- Bruising;
- Hair loss;
- Increased sensitivity to light.
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
| COMMON | |||
Gastrointestinal (GI) problems (bleeding, blockage, holes, ulcers or inflammation in your GI tract): blood in vomit, black tarry or bloody stool, dizziness, stomach pain, bloating, loss of appetite, weight loss, nausea, vomiting, constipation or diarrhea, chills or fever | ✓ | ||
| Hypertension (high blood pressure): fatigue, dizziness or fainting, chest pain | ✓ | ||
| UNCOMMON | |||
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
Anaphylaxis/hypersensitivity (severe allergic reactions): sudden wheeziness and chest pain or tightness; or swelling of eyelids, face, lips, tongue or throat, swelling or anaphylactic reaction/shock | ✓ | ||
Aseptic meningitis (inflammation of the protective lining of the brain that is not caused by infection): Headaches, stiff neck, nausea and vomiting, fever or clouding of consciousness | ✓ | ||
| Blood problems (low white and/or red blood cell or platelet count): feeling tired or weak, pale skin, bruising or bleeding for longer than usual if you hurt yourself, fever, chills | ✓ | ||
| Congestive heart failure (heart does not pump blood as well as it should): shortness of breath, fatigue and weakness, swelling in ankles, legs and feet, cough, fluid retention, lack of appetite, nausea, rapid or irregular heartbeat, reduced ability to exercise | ✓ | ||
| Cystitis (bladder infection): increased need to urinate, pain in the pelvis or lower back, frequent urination during the night, cloudy urine that may contain blood, burning or pain urinating | ✓ | ||
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
Depression (sad mood that will not go away): difficulty sleeping or sleeping too much, changes in appetite or weight, reduced sex drive and thoughts of death or suicide. | ✓ | ||
Kidney disorder/problems (including kidney failure and renal papillary necrosis): nausea, vomiting, fever, swelling of extremities, fatigue, thirst, dry skin, irritability, dark urine, increased or decreased urine output, blood in the urine, rash, weight gain (from retaining fluid), loss of appetite, mental status changes (drowsiness, confusion, coma, painful urination, chills, back pain) | ✓ | ||
Liver problems (including hepatitis, liver failure, cholestasis): yellowing of your skin and eyes (jaundice), right upper stomach area pain or swelling, nausea or vomiting, unusual dark urine, unusual tiredness | ✓ | ||
| Lung problems (including asthma): increased shortness of breath, wheezing, difficulty breathing, cough, chest tightness, irregular heartbeat, lung infection, chest pain, fever | ✓ | ||
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
| Myocardial infarction (heart attack): pressure or squeezing pain between the shoulder blades, in the chest, jaw, left arm or upper abdomen, shortness of breath, dizziness, fatigue, light-headedness, clammy skin, sweating, indigestion, anxiety, feeling faint and possible irregular heartbeat. | ✓ | ||
| Stroke (bleeding or blood clot in the brain): sudden numbness, weakness or tingling of the face, arm, or leg, particularly on one side of the body, sudden headache, blurry vision, difficulty swallowing or speaking, or lethargy, dizziness, fainting, vomiting, trouble understanding, trouble with walking and loss of balance | ✓ | ||
Tinnitus (hearing problems): includes ringing, buzzing, clicking or hissing in ears, loss of hearing | ✓ | ||
Vertigo (a sense of severe spinning dizziness, light headedness) | ✓ | ||
| RARE | |||
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
| Serious skin reactions: fever, severe rash, swollen lymph glands, flu-like feeling, blisters and peeling skin that may start in and around the mouth, nose, eyes and genitals and spread to other areas of the body, swelling of face and/or legs, yellow skin or eyes, shortness of breath, dry cough, chest pain or discomfort, feeling thirsty, urinating less often, less urine or dark urine, red or dry itchy skin, purple or red spots on skin | ✓ | ||
| UNKNOWN FREQUENCY | |||
| Eye problems: blurred vision, loss of part or all of central vision, reduced colour vision, dimness of vision. | ✓ | ||
If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.
Reporting Side Effects
You can report any suspected side effects associated with the use of health products to Health Canada by:
NOTE: Contact your healthcare professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice. |
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Storage:
- Store MAR-KETOROLAC at room temperature (15o C to 30oC) away from light and excessive humidity.
- Do NOT keep expired medicine or medicine no longer needed. Return to your healthcare professional.
- Keep out of reach and sight of children.
If you want more information about MAR-KETOROLAC:
- Talk to your healthcare professional
- Find the full product monograph that is prepared for healthcare professionals and includes the Patient Medication Information by visiting the Health Canada Drug Product Database website (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); the manufacturer’s website www.marcanpharma.com; or by calling 1-855-627-2261.
