Ketorolac Ophthalmic

pronounced as (kee toe role' ak)

Brand Name(s): Acular®, Acuvail®, also available generically

Why is this medicine prescribed?

Ophthalmic ketorolac is used to treat itchy eyes caused by allergies. It also is used to treat swelling and redness (inflammation) that can occur after cataract surgery. Ketorolac is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the release of substances that cause allergy symptoms and inflammation.

Are there other uses for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Ophthalmic ketorolac comes as a solution (liquid) to instill in the eyes. For allergy symptoms, one drop is usually instilled in the affected eyes four times a day. For inflammation after cataract surgery, one drop is usually instilled in the affected eye four times a day for 2 weeks beginning 24 hours after surgery. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ketorolac ophthalmic exactly as directed. Do not use more or less of it or use it more than prescribed by your doctor.

Your allergy symptom (itchy eyes) should improve when you instill the eye drops. If your symptoms do not improve or if they worsen, call your doctor.

For treatment of itchy eyes caused by allergies, continue to use ketorolac eye drops until you are no longer exposed to the substance that causes your symptom, allergy season is over, or your doctor tells you to stop using it.

To instill the eye drops, follow these steps:

  1. Wash your hands thoroughly with soap and water.
  2. Check the dropper tip to make sure that it is not chipped or cracked.
  3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.
  4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.
  5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
  6. Brace the remaining fingers of that hand against your face.
  7. While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
  8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.
  9. Place a finger on the tear duct and apply gentle pressure.
  10. Wipe any excess liquid from your face with a tissue.
  11. If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.
  12. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
  13. Wash your hands to remove any medication.

What special precautions should I follow?

Before using ketorolac eye drops,

  • tell your doctor or pharmacist if you are allergic to ketorolac, aspirin, or any other medications.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while using ketorolac eye drops. Your doctor may need to change the doses of your medications or monitor you carefully for side effects..
  • the following nonprescription products may interact with ketorolac eye drops: aspirin; nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Ibu-Tab, Motrin, others) and naproxen (Aleve, others). Be sure to let your doctor and pharmacist know that you are taking using medications before you start using ketorolac eye drops. Do not start any of these medications while using ketorolac eye drops without discussing with your healthcare provider.
  • tell your doctor if you have or have ever had heart, kidney, or liver disease or bleeding problems.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.
  • tell your doctor if you wear soft contact lenses. You should not use ketorolac eye drops while wearing your soft contact lenses.
  • use caution when driving or operating machinery because your vision may be blurred after you instill the drops.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget to take a dose?

Instill the missed dose as soon as you remember it. However, if is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not instill a double dose to make up for a missed one.

What should I do in case of overdose?

If someone swallows ketorolac eye drops, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What side effects can this medicine cause?

Ketorolac eye drops may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • stinging and burning of the eyes
  • blurry vision

Some side effects can be serious. If you experience any of the following symptoms, stop using ketorolac eye drops and call your doctor immediately:

  • redness or swelling of eyes, lips, tongue, or skin
  • infection in or around the eye
  • skin rash, hives, or skin changes
  • difficulty breathing or swallowing

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( http://www.fda.gov/Safety/MedWatch ) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( http://goo.gl/c4Rm4p ) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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