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It is one of the most widely used pain relievers for the treatment of moderate pain after surgery. Here is the complete guide.
What is Tora-Dol?
Tora-Dol is an anti-inflammatory and antirheumatic drug. Its active substance is ketorolac tromethamine. Therefore, it belongs to the category of non-steroidal anti-inflammatory drugs, also called NSAIDs. These medicines are the most used against inflammation because:
- they are able to reduce and block the inflammatory process;
- they have pain relievers, therefore, anti-pain properties;
- they have antipyretic abilities, therefore they can lower fever.
It is a prescription medication that must be renewed from time to time.
Therapeutic indications for Tora-Dol
This medication is only prescribed for the short-term treatment of moderate postoperative pain for up to 5 days. It should not be used in cases of mild or chronic pain. It can also be used against toothache, especially after dental work.
A doctor’s prescription is mandatory.
Who cannot use Tora-Dol?
Intake of Tora-Dol should be excluded in people who are hypersensitive or allergic to kerotolac or aspirin, or to other non-steroidal anti-inflammatory drugs.
Anyone that:
- have aulceror have you had agastrointestinal bleeding;
- Suffer from nasal polypssay asthma angioedema or of bronchospasm;
- experiencing a condition of severe heart failure or moderate or severe kidney failure;
- both in intensive diuretic therapy;
- Suffer from cirrhosis liver or hepatitis severe
- have clotting problems;
- suffers from problems related to platelet function;
- you are under 16;
- both in the third trimester of pregnancy, during labor, delivery and lactation.
Usage precautions and warnings.
If used for a long time without the supervision of a doctor, it can give a high risk of severe gastrointestinal toxicity.
Elderly people should pay special attention to taking Tora-Dol. Side effects are much more frequent. In addition to taking for a very limited time, the doctor will indicate a longer interval between doses, compared to younger adults.
Those who suffer or have suffered from gastrointestinal diseases, such as ulcerative colitis or the mCrohn’s disease they must be very careful when using this medicine. The same is true for those with cardiovascular disease, such as hypertension or mild or moderate heart failure or vasculitis.
Women of childbearing age should always undergo a pregnancy test before starting Tora-Dol therapy.
Abuse and addiction
The active ingredient is not addictive. No withdrawal symptoms were observed after an abrupt discontinuation of Ketorolac.
fertility
Its use is not recommended for women who want to become pregnant.
pregnancy
As already mentioned, Tora-Dol should not be used during the third trimester of pregnancy, labor, delivery, and while breastfeeding. Even in the first six months of pregnancy, it should only be taken in strictly necessary cases.
If ketorolac is used by a woman at the conception stage, or during the first and second trimesters of pregnancy, the dose and duration of treatment should be kept as low as possible.
lactation
The active substance passes into breast milk. Consequently, it should never be used during lactation.
Effects on ability to drive and use machines.
Side effects include drowsiness, dizzinessdizziness, insomnia, or depression. Therefore, great care must be taken when driving vehicles and using machines.
Tora-Dol interactions with other drugs
As always, you should inform your doctor if you are taking other medications or dietary supplements.
- Simultaneous use of Tora-Dol and other NSAIDs or aspirin is not possible.
- Also take it together with corticosteroids, since it increases the risk of gastrointestinal bleeding.
- The same is true with aggregating agents or anti-anxiety drugs.
- Increases the risk of bleeding even when taken together with pentoxifylline.
Special attention should be paid if together with Tora-Dol you are taking:
- anticoagulantsAs the warfarin, increases its effects, while decreasing the effect of diuretics and other antihypertensive drugs;
- probenecid, a gout medication;
- methotrexate, a cancer drug, because it increases its toxicity;
- lithium, because there is a risk of reaching the toxic threshold.
Warning: taking ketorolac after a high-fat meal delays its effectiveness by one hour. Antacids, on the other hand, do not affect their assimilation.
Dosage and methods of using Tora-Dol
Tora-Dol tablets and drops
You should never take Tora-Dol for more than five days unless your doctor decides. The prescribed dose should be the lowest effective dose. The dose should be appropriately reduced in subjects weighing less than 50 kilograms. The oral drop formulation is particularly indicated in patients with difficulty swallowing.
Dose in adults
The recommended dose in adults is 1 tablet or 10 drops of solution every 4-6 hours up to a maximum of 4 tablets or 40 drops per day.
Dose in the elderly aged 65 years or older.
The doctor will decide the dose case by case.
Tora-Dol injectable ampoules
The injectable solution contains ethanol, therefore it should not be used epidurally or intrathecally.
Parenterally, the duration of therapy should not exceed 2 days in the case of bolus administration and 1 day in the case of continuous infusion.
Intramuscular administration
ADULTS
In adults, it is recommended to start with the 10 mg dose followed by 10-30 mg doses that are repeated every 4-5 hours, as necessary, up to a maximum of 90 mg / day, using the minimum effective dose.
The duration of therapy should not exceed 2 days.
On the day of the transition from parenteral to oral therapy, the total daily dose of 90 mg should not be exceeded, remembering that the maximum oral dose should not exceed 40 mg.
The dose should be appropriately reduced in subjects weighing less than 50 kg.
Elderly (> 65 years)
In the elderly patient, the dose should be carefully established by the doctor, who should evaluate a possible reduction of the doses indicated above.
However, in elderly patients, the maximum daily dose should not exceed 60 mg / day.
Intravenous administration
THE INTRAVENOUS USE OF THE PREPARATION IS RESERVED FOR HOSPITALS AND CARE.
ADULTS
In situations characterized by severe acute pain (as in postoperative pain attack therapy) an initial dose of 10 mg is recommended, followed by doses of 10-30 mg that can be repeated, if necessary, after 4 -6 hours, using the minimum effective dose. If necessary, treatment can continue at longer intervals; however, the daily dose of 90 mg should not be exceeded.
Elderly (> 65 years)
However, in elderly patients, the maximum daily dose should not exceed 60 mg / day.
Renal colic
The recommended dose is one 30 mg ampoule for intramuscular or intravenous administration. If you have any questions about the use of the medicine, ask your doctor or pharmacist.
Pediatric and child use.
The drug is contraindicated in children under the age of 16. Therefore, it is up to the doctor to determine if the drug is really essential in young children and adolescents.
What should I do if I overdosed on Tora-Dol?
Symptoms of an overdose of this medicine are:
- sickness,
- vomiting
- abdominal pain
- hyperventilation,
- peptic ulcer
- gastritis,
- kidney dysfunction
- gastrointestinal bleeding,
- in rare cases, hypertension, acute kidney failure, respiratory depression and coma.
There are no specific antidotes. If you have taken too much Tora-Dol, you should notify your doctor immediately or go to the nearest emergency department.
Tora-Dol side effects
Like all medicines, Tora-Dol also has side effects, although not everyone who takes them experiences them.
Side effects can be minimized by using the lowest effective dose for the shortest possible treatment time necessary to control symptoms.
The main side effects refer to the gastrointestinal system. The following may occur:
- peptic ulcer
- ulcer,
- gastrointestinal perforation or bleeding,
- sickness,
- vomiting
- diarrhea,
- flatulence,
- constipation;
- abdominal pain
- feeling of fullness
- rectal bleeding,
- stomatitis or ulcerative stomatitis,
- esophagitis,
- belching,
- pancreatitis,
- dry mouth
The other side effects of this medicine are:
- allergic reactions, such as bronchospasm, vasodilation, redness, rash, hypotension, laryngeal edema, that is, swelling of the larynx with evident difficulty in breathing;
- headache, dizziness, dizziness, seizures;
- lack of appetite
- paresthesia, that is, tingling;
- hyperkinesis, that is, an involuntary and uncontrolled movement of the muscles;
- changes in taste
- cardiovascular problems, such as palpitations, bradycardia, heart failure, edema, hypertension and heart failure;
- psychiatric disorders such as insomnia, anxiety, irritability, abnormal dreams, confusion, hallucinations, euphoria, decreased concentration, numbness;
- vision disorders, abnormal vision;
- tinnitus, hearing loss, dizziness;
- respiratory problems, such as pulmonary edema, asthma and dyspnea, that is, shortness of breath;
- meningitis aseptic;
- thrombocytopenia, that is, the reduction in the number of platelets in the blood;
- purple;
- epistaxis, that is, the leakage of blood from the nose;
- severe allergic reactions, such as Stevens-Johnson syndrome, with rashes typically around the eyes, nose, mouth, and genitals, the toxic epidermal necrolysis, which leads to the detachment of the skin on more than a third of the body surface anderythema multiforme, which manifests as vesicles with a dark spot in the center surrounded by a lighter area
Storage and expiration
The expiration date is clearly indicated on the package. It can also be found in each blister or inner lining. The date refers to the medicine stored correctly. It should never be used after this expiration date.
Drugs should never be thrown in an unsorted bin. They can be very harmful to human and environmental health. That is why they are collected and treated separately from other waste. Each region, often each municipality, decides where to collect them. It is good to ask. Many pharmacies offer collection services for expired medications.
All medications should be kept out of the reach of children.
Price for Tora-Dol
- Tora-Dol 10 mg 10 film-coated tablets € 13.50
- Tora-Dol 10 mg / ml solution for injection 6 ampoules € 9.80
- Tora-Dol 20 mg / ml solution for oral drops 10 ml 13.85
- Tora-Dol 30 mg / ml solution for injection 3 ampoules 4.06 euros.
