Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

  1. Acular
  2. Acular LS
  3. Acular PF
  4. Acuvail

Canadian Brand Name

  1. Apo-Ketorolac
  2. Ratio-Ketorolac

Descriptions


Ketorolac eye drops is used to treat itching caused by seasonal allergic conjunctivitis (an allergy that occurs at only certain times of the year). It is also used to treat pain, burning, and inflammation of the eye following cataract surgery or corneal refractive surgery. This medicine is a topical nonsteroidal anti-inflammatory drug (NSAID).

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Solution

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of Acular LS® eye drops in children younger than 3 years of age. Safety and efficacy have not been established.

Appropriate studies have not been performed on the relationship of age to the effects of Acular® eye drops in children younger than 2 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ketorolac eye drops in the elderly.

Breastfeeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Aceclofenac
  • Acemetacin
  • Amtolmetin Guacil
  • Aspirin
  • Bromfenac
  • Bufexamac
  • Celecoxib
  • Choline Salicylate
  • Clonixin
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Droxicam
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Ibuprofen
  • Indomethacin
  • Ketoprofen
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Pentoxifylline
  • Phenylbutazone
  • Piketoprofen
  • Piroxicam
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • Sulfasalazine
  • Sulindac
  • Tenoxicam
  • Tiaprofenic Acid
  • Tolfenamic Acid
  • Tolmetin
  • Valdecoxib

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abciximab
  • Acenocoumarol
  • Anagrelide
  • Apixaban
  • Ardeparin
  • Argatroban
  • Bemiparin
  • Bivalirudin
  • Budesonide
  • Cangrelor
  • Certoparin
  • Cilostazol
  • Citalopram
  • Clopidogrel
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Deflazacort
  • Desirudin
  • Desvenlafaxine
  • Dexamethasone
  • Dipyridamole
  • Duloxetine
  • Edoxaban
  • Emtricitabine
  • Enoxaparin
  • Epoprostenol
  • Eptifibatide
  • Escitalopram
  • Feverfew
  • Fluoxetine
  • Fluvoxamine
  • Fondaparinux
  • Ginkgo
  • Heparin
  • Hydrocortisone
  • Iloprost
  • Lepirudin
  • Levomilnacipran
  • Meadowsweet
  • Melphalan
  • Methotrexate
  • Methylprednisolone
  • Milnacipran
  • Nadroparin
  • Nefazodone
  • Parnaparin
  • Paroxetine
  • Phenindione
  • Phenprocoumon
  • Prasugrel
  • Prednisolone
  • Prednisone
  • Protein C
  • Reviparin
  • Rivaroxaban
  • Selexipag
  • Sertraline
  • Sibutramine
  • Sulfinpyrazone
  • Sulodexide
  • Tenofovir Alafenamide
  • Ticagrelor
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Treprostinil
  • Venlafaxine
  • Vilazodone
  • Vorapaxar
  • Vortioxetine
  • Warfarin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergy to NSAIDs (eg, aspirin, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®) or
  • Asthma, or history of or
  • Bleeding problems or
  • Bronchospasm (breathing problem)—Use with caution. May make these conditions worse.
  • Corneal (front part of the eye) denervation or
  • Corneal (front part of the eye) epithelial defects or
  • Diabetes or
  • Ocular (eye) surface diseases (eg, dry eye syndrome) or
  • Ocular (eye) surgeries, complicated or
  • Ocular (eye) surgeries, multiple within a short period of time or
  • Rheumatoid arthritis—Use with caution. May increase the risk of having serious eye problems.

Proper Use

Your eye doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to. This medicine is not for long-term use.

This medicine can be used with other ophthalmic (eye) medicines. Wait at least 5 minutes before using another eye medicine.

If you or your child are wearing contact lenses, remove them while you are using this medicine. Talk to your eye doctor about this if you have questions.

If you are using this medicine after an eye surgery, use one bottle for each eye only. Use of the same bottle of eye drops for both eyes is not recommended.

To use the eye drops:

  • First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed for 1 or 2 minutes to allow the medicine to be absorbed by the eye.
  • Immediately after using the eye drops, wash your hands to remove any medicine that may be on them.
  • If you think you did not get the drop of medicine into your eye properly, use another drop.
  • To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, always keep the container tightly closed.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For ophthalmic dosage form (eye drops):
    • For relief of eye itching caused by seasonal allergic conjunctivitis:
      • Adults and children 2 years of age and older—Use one drop in the affected eye(s) 4 times a day.
      • Children younger than 2 years of age—Use and dose must be determined by your doctor.
    • For eye swelling following cataract surgery:
      • Adults and children 2 years of age and older—Use one drop in the affected eye(s) 4 times a day beginning 24 hours after surgery and for 2 weeks after the surgery.
      • Children younger than 2 years of age—Use and dose must be determined by your doctor.
    • For eye pain, burning, or stinging following corneal refractive surgery:
      • Adults and children 3 years of age and older—Use one drop in the affected eye(s) 4 times a day for up to 4 days after the surgery.
      • Children younger than 3 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

Your eye doctor will check your or your child's eyes at regular visits to make sure it is working properly and is not causing unwanted effects.

If your or your child's symptoms do not improve within a few days or if they become worse, check with your doctor.

Slow or delayed healing may occur while you or your child are using this medicine. Ask your doctor before using this medicine together with a topical corticosteroid (eg, betamethasone, hydrocortisone).

Using this medicine may increase risk of having corneal (front part of the eye) problems, including keratitis. Check with your eye doctor right away if you or your child have blurred vision, changes in vision, or eye redness, irritation, or pain while using this medicine.

Make sure your doctor knows if you are pregnant. Do not use this medicine during the later part of a pregnancy, unless your doctor tells you to.

If you hurt your eye, develop an eye infection, or need to have eye surgery, talk with your doctor right away. You may need to change your medicine or stop using it.

While applying this medicine, your eyes will probably sting or burn for a short time. This is to be expected.

Do not use other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Itching, redness, tearing, or other sign of eye irritation not present before use of this medicine or becoming worse during use
  2. redness of the clear part of the eye
  3. sensitivity to light
  4. swelling of the eye
  5. swelling of the eyelids
  6. tearing
  7. throbbing pain

Rare

  1. Blurred vision or other change in vision
  2. eye irritation or redness

Incidence not known

  1. Cough
  2. noisy breathing
  3. tightness in the chest
  4. trouble breathing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Stinging or burning of the eye when medicine is applied

Rare

  1. Dry eyes
  2. headache

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: April 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/ketorolac-ophthalmic-route/side-effects/DRG-20064486