Kepros

Ketorolac

Method of action: Analgesic, Analgetic, Anti-Inflammatory, Antipyretic, Nonsteroidal Anti-Inflammatory, Ophthalmologic Agent, Ophthalmologicals

Treatment option: Pain, Toothache, Colic, Surgery

Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Kepros

Kepros is a potent medication for the short-term management of acute pain. Its purpose is to deliver strong, non-narcotic pain relief, often functioning as an opioid-sparing agent.

Property	Description
Active Ingredient	Ketorolac Tromethamine
Pharmacological Class	Nonsteroidal Anti-Inflammatory Drug (NSAID)
Form Variety	Oral tablets, Injectable solution, Ophthalmic solution, Nasal spray
Common Use	Acute Pain Relief
Origin	Synthetic (Acetic acid derivative)

Type and Classification of Ketorolac

Kepros is a commercial preparation containing the active substance Ketorolac Tromethamine. It is formally classified as a Nonsteroidal Anti-Inflammatory Drug (NSAID), a group of medicines known for their anti-inflammatory, analgesic (pain-relieving), and antipyretic (fever-reducing) properties. Chemically, Ketorolac is a synthetic acetic acid derivative.

Compared to common over-the-counter NSAIDs, Ketorolac is known for its significantly higher analgesic potency. The medicine is used for pain and is part of the treatment for fever and swelling. This enhanced capability is clinically recognized for managing intensive pain, such as that experienced immediately following a surgical procedure.

Composition and General Benefit

As a single-ingredient product, Kepros relies solely on the effect of Ketorolac Tromethamine. It is prepared using various pharmaceutical components to create its versatile range of administration types, which include oral tablets, an injectable solution for parenteral use, a specialized ophthalmic solution, and a nasal spray. This variety allows for administration via oral, parenteral, ocular, and nasal routes.

Its general benefit stems from its mechanism as a non-selective Cyclooxygenase inhibitor. Ketorolac effectively inhibits prostaglandin synthesis. This means the drug works by blocking the core chemical signals—prostaglandins—that are primarily responsible for transmitting pain signals and initiating inflammation and fever, delivering comprehensive relief during acute episodes.

What side effects are possible with Kepros?

The officially documented safety profile for Ketorolac Tromethamine (Kepros) is governed by a focus on serious, potentially fatal adverse reactions and strict limitations on use. The risk of these severe events is documented by regulatory authorities to be dose-dependent and to increase with the duration of treatment.

Serious Adverse Reactions

The regulatory labeling highlights several serious complications. These include gastrointestinal (GI) ulceration, bleeding, and perforation, which can occur without warning symptoms and may be fatal. As a Nonsteroidal Anti-Inflammatory Drug (NSAID), Ketorolac is associated with an increased risk of serious cardiovascular thrombotic events, such as myocardial infarction (heart attack) and stroke. Other severe risks documented include acute renal failure, liver failure, and anaphylactic reactions.

Common Adverse Effects and Organ Systems

The most frequently reported effects, generally occurring in approximately 1% to 10% of patients in clinical trials, typically involve the digestive and nervous systems:

Gastrointestinal: Nausea, dyspepsia (indigestion), abdominal pain, flatulence, and diarrhea/constipation.
Nervous System: Headache, dizziness, and drowsiness.
Other: Edema (swelling due to fluid retention), hypertension (elevated blood pressure), and pruritus (itching).

Population-Specific Safety Constraints

Safety documents specify that older adults are at a greater risk for serious GI and renal adverse events. The medication is contraindicated in patients with advanced renal impairment, active peptic ulcer disease, or a history of GI bleeding. Furthermore, its use is contraindicated during the third trimester of pregnancy and during lactation due to potential risks to the fetus or infant. The label also prohibits its use in the setting of coronary artery bypass graft (CABG) surgery and in combination with other NSAIDs or aspirin.

Overdose and Emergency Response

Official Overdose Manifestations

Kepros overdose is typically managed by symptomatic and supportive care, as regulatory documents confirm that no specific antidote is known. Patients should seek immediate medical attention for any suspected overdose to initiate appropriate assessment and monitoring.

Documented clinical signs often affect the gastrointestinal and central nervous systems, including lethargy, drowsiness, nausea, vomiting, and epigastric pain. Other manifestations cited in official labeling are abdominal pain and hyperventilation.

Severe Outcomes and Emergency Actions

While many signs are reversible, severe outcomes, although rare, are listed in regulatory profiles, including acute renal failure, respiratory depression, coma, hypertension, and significant gastrointestinal bleeding.

For large oral overdoses (5 to 10 times the usual dose) seen within four hours, official management protocols may indicate procedures such as the administration of activated charcoal, emesis, and/or an osmotic cathartic. Regulatory guidance notes that elderly patients are at greater risk for serious gastrointestinal events, which is an important consideration in overdose management.

Therapeutic Uses of Kepros

What Kepros Treats: Main Uses and Benefits

Kepros is applied in conditions characterized by periods of heightened symptoms related to physical discomfort that are moderate to severe in intensity, such as those stemming from injuries or the immediate post-surgical period. This medication is indicated specifically for providing short-term symptomatic assistance.

It is relevant for easing intense symptomatic discomfort, generally offering patients non-narcotic pain control during periods of high distress. The medication is commonly used to help with the symptom cluster of localized inflammation, swelling, and tenderness, as well as in clinical settings that involve acute or unstable symptom patterns, including acute pain intervention like that seen with renal colic. It is considered relevant because it may offer an opioid-sparing effect, which assists with maintaining functional stability and may be part of a strategy that supports reducing reliance on narcotic medications.

“It is relevant when supportive symptom management is appropriate in acute, unstable pain patterns, helping patients cope more steadily with difficult episodes.”

Quick Fact: Relief for Acute, Moderate to Severe Pain Kepros is generally used to provide short-term, supportive symptomatic relief in clinical scenarios where pain is intense and temporary, such as during the immediate recovery phase after surgery. It contributes to easing the overall symptom load.

Regulatory References

NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

Kepros (Ketorolac Tromethamine) is intended for use in the adult population and is subject to several strict population-eligibility rules established by regulatory authorities.

Populations Who Must Not Use Kepros (Contraindications)

Use is absolutely prohibited in several high-risk groups to prevent serious complications:

Gastrointestinal Risk: Patients with active peptic ulcer disease or a history of recent gastrointestinal bleeding or perforation.
Bleeding Risk: Patients with suspected or confirmed cerebrovascular bleeding, hemorrhagic diathesis, or incomplete hemostasis.
Renal Impairment: Patients with advanced or moderate-to-severe renal impairment or those at risk for renal failure due to volume depletion.
Allergy/Sensitivity: Individuals with known hypersensitivity to Ketorolac Tromethamine or allergic reactions to aspirin or other NSAIDs.
Surgical Settings: Contraindicated for the treatment of peri-operative pain in the setting of Coronary Artery Bypass Graft (CABG) surgery and as prophylactic analgesia before major surgery.
Concurrent Medication: Patients currently receiving aspirin or any other Nonsteroidal Anti-Inflammatory Drugs (NSAIDs).

Age and Reproductive Status Restrictions

Population Group	Eligibility Status (Regulatory Labeling)
Pediatric Population	Use is not recommended; safety and efficacy are not established in children (typically under 16 years).
Older Adults	Use is permitted, but requires conditional use and a reduced maximum daily dose due to increased risk of side effects.
Pregnancy	Contraindicated during the third trimester and during labor and delivery.
Lactation (Breastfeeding)	Contraindicated.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Kepros (Ketorolac Tromethamine) has officially documented interactions, which result in several mandatory restrictions on co-administration according to regulatory information. These restrictions are primarily due to documented additive risks or changes in drug clearance.

Formal Contraindicated Combinations

The following combinations are explicitly prohibited in official prescribing information due to clinically significant interaction risks:

Classification	Interacting Substances/Classes
Additive Bleeding Risk	Warfarin and other Anticoagulants, Anti-platelet Agents (including Aspirin/ASA), and Oxpentifylline
Increased Exposure	Probenecid (decreases Ketorolac clearance) and Lithium Salts (Ketorolac decreases Lithium clearance)
Synergistic Risk	Other Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), including cyclooxygenase-2 selective inhibitors, and other Ketorolac formulations

Mechanism of Action

Cyclooxygenase Enzyme Inhibition: Blocking the Molecular Source

Kepros (Ketorolac Tromethamine) achieves its physiological consequences by intervening through the fundamental mechanism of inhibiting the Cyclooxygenase (COX) enzymes. The molecule acts as a non-selective, reversible inhibitor, targeting both the constitutive COX-1 and the inducible COX-2 isoforms. This mechanism intervenes early in the Arachidonic Acid Pathway, thereby suppressing the production of downstream signaling molecules known as prostanoids.

Prostaglandin Suppression and Nociceptor Desensitization

The suppression of COX-2-dependent activity results in a significant reduction of Prostaglandin E2 ( PGE2) at sites of tissue damage. Reduced PGE2 production limits the chemical sensitization of peripheral nerve endings (nociceptors). This dampening of peripheral nociception is the molecular basis for the drug's effect on pain signaling. Furthermore, the molecular blockade of PGE2 in the hypothalamus suppresses the central mechanism responsible for elevating the thermoregulatory set point.

Non-Selective Action and Physiological Trade-Offs

The non-selective nature of the mechanism extends to the homeostatic role of COX-1, limiting the synthesis of protective prostaglandins in various systems. This mechanistic trade-off constrains biological processes such as the prostaglandin-mediated maintenance of the gastric mucosal barrier and the compensatory vasodilation required to preserve renal blood flow under physiological stress. The action of the mechanism is constrained or physiologically counter-regulated in these contexts.

Dosage and Administration Information

How Kepros is Used

Kepros (ketorolac tromethamine) is administered through several officially approved administration routes for both systemic and localized therapy, including intravenous (IV) or intramuscular (IM) injection, oral tablets, an intranasal spray, and ophthalmic solutions. The primary principle for systemic and nasal usage is a strict short-term limitation: the combined total duration of use across all such forms in adult patients must not exceed 5 days.

Systemic Administration Rules

Systemic therapy is always initiated with the injectable form (IV or IM). The oral tablet is formally indicated only as continuation therapy following a course of injectable dosing, and should not be used as an initial treatment.

For adults under 65 years and weighing 50 kg or more, the typical regimen for multiple-dose IV or IM is 30 mg every 6 hours, with a maximum daily dose of 120 mg. The intravenous bolus injection must be administered over a period of no less than 15 seconds.

Dose Adjustment for Specific Populations

Standard administration protocols specify a reduced maximum daily dose for certain populations. Patients who are 65 years of age or older, who weigh less than 50 kg, or who have moderately elevated serum creatinine should not receive more than 60 mg per day of the injectable solution.

Nasal and Ophthalmic Use

The intranasal spray is utilized for short-term pain management, typically administered as 31.5 mg every 6 to 8 hours for non-elderly patients. The nasal spray must be discarded within 24 hours after the first dose, irrespective of remaining contents. The ophthalmic solution is usually applied as one drop four times a day for localized ocular conditions.

Recent Clinical Evidence

Research evidence / Overview of studies

Research Focus and Initial Findings

Research has evaluated whether patient outcomes in X condition are associated with Y treatment. Research focused on understanding the drug’s role in the body. Research explored how the drug might affect the body. The initial effects of the drug were examined in laboratory and animal studies before human trials began.

Findings from Clinical Research

Clinical trials investigated the treatment’s effect on pain; some findings indicated that subjects who received the treatment reported different results on established rating scales. Research evaluated the outcomes of the combination therapy. Some studies noted the timing of observed change compared to placebo groups.

Research compared the outcomes of this treatment with existing therapies in a Phase 3 study involving 500 participants. Study findings indicated that the percentage of subjects achieving a predetermined clinical endpoint was similar across the treatment groups.

Dosing and Tolerability

Studies explored the relationship between the higher dose and observed changes in symptoms over time. Findings from a retrospective cohort study indicated that a relationship was observed between a higher daily dose and differences were observed in the duration of changes to symptoms compared to those on a lower dose.

Studies collected information regarding how subjects tolerated the treatment during prolonged use. Studies examined the effects of abrupt cessation of treatment; some trial participants experienced changes upon cessation of treatment.

Ongoing Research

Current efforts are exploring whether this treatment may be associated with observed changes in related comorbidities, specifically investigating its interaction with cardiovascular markers. Evidence remains limited, and the need for long-term studies to evaluate the effects on a broader population has been identified.

Key Studies & References

Frequently Asked Questions (FAQ)

Common questions about Kepros (FAQ)

Q: Is Kepros (Ketorolac) a narcotic or opioid?

According to official product information, Kepros (Ketorolac Tromethamine) is not classified as a narcotic or an opioid. It belongs to the class of medicines called Nonsteroidal Anti-Inflammatory Drugs (NSAIDs).

Its purpose is often described as providing effective management for acute, short-term pain, which is consistent with its non-opioid mechanism of action.

Q: Can I drink alcohol while taking Kepros?

Regulatory warnings indicate that the use of alcohol is associated with an increased risk of serious gastrointestinal side effects, such as bleeding and ulceration, when combined with NSAIDs like Kepros.

This information suggests a potential for heightened risk to the stomach and digestive system when combining the two substances.

How should Kepros be stored and disposed of?

Kepros (Ketorolac Tromethamine) must be stored strictly according to regulatory labeling to maintain its stability.

Storage Condition	Requirement	Constraint
Temperature	Controlled Room Temperature: 20 C to 25 C (68 F to 77 F).	Do not freeze or refrigerate the injectable solution.
Protection	Keep in the original container, tightly closed. Protect from light and moisture.	Store out of the sight and reach of children.
Stability	Ophthalmic Solution: Discard unused portion one month after opening. Injectable Solution: Use immediately after opening; discard residue.
Disposal	Use an FDA-authorized drug take-back program. If unavailable, mix with an undesirable substance (e.g., used coffee grounds) and seal in a bag before disposal in household trash. Do not dispose of via wastewater.