Ketorolaco
Ketorolac
Ketorolac tromethamine
También conocido como: Toradol · Acular · RS-37619-00-31-3 · Ketorolac trometamol
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As an analgesic | 0.5 mg/kg IV three times daily or 0.3 mg/kg PO twice daily | IV, PO | TID (IV) or BID (PO) | < 3 days | 🌎 NA |
| As an analgesic | 0.3-0.5 mg/kg IV , IM q8-12h for one or two doses | IV, IM | q8-12h | 1-2 doses | 🌎 NA |
| Anterior uveitis and ulcerative keratitis | 1 drop per eye | topical | q6-24h | — | 🌍 EU |
- As an analgesic: Repeated doses have considerable potential for causing GI or renal toxicity. Treated dogs should receive misoprostol.
- Anterior uveitis and ulcerative keratitis: Frequency depends on the severity of inflammation.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As an analgesic | 0.25 mg/kg IM q8-12h for one or two doses | IM | q8-12h | 1-2 doses | 🌎 NA |
| Anterior uveitis and ulcerative keratitis | 1 drop per eye | topical | q6-24h | — | 🌍 EU |
- Anterior uveitis and ulcerative keratitis: Frequency depends on the severity of inflammation.
Pequeños mamíferos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As an analgesic (Mice) | 0.7-10 mg/kg PO once daily | PO | once daily | — | 🌎 NA |
| As an analgesic (Rats) | 3-5 mg/kg PO once to twice a day; 1 mg/kg IM once to twice a day | PO, IM | once to twice a day | — | 🌎 NA |
Cabras
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As an analgesic | 0.3-0.7 mg/kg IV , IM, SC, PO three times daily | IV, IM, SC, PO | three times daily | — | 🌎 NA |
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El ketorolaco es un antiinflamatorio no esteroideo (AINE) altamente potente utilizado principalmente para la analgesia a corto plazo en medicina veterinaria.
- Nota clínica: Aunque el ketorolaco proporciona un alivio del dolor profundo (a menudo comparado con los opioides en medicina humana), su uso en perros y gatos es altamente controvertido y generalmente desaconsejado debido a la disponibilidad de AINEs más seguros y aprobados para uso veterinario.
- Conlleva un riesgo muy alto de toxicidad gastrointestinal (ulceración y perforación) y toxicidad renal, especialmente con la administración repetida.
- Si se utiliza en perros, la mayoría de los clínicos limitan estrictamente el tratamiento a menos de 3 días y recomiendan encarecidamente la administración concurrente de gastroprotectores como el misoprostol (con o sin sucralfato).
Mecanismo de acción
Ketorolac exerts its analgesic, anti-inflammatory, and antipyretic effects by non-selectively inhibiting cyclooxygenase (COX-1 and COX-2) enzymes.
Arachidonic Acid → COX-1/COX-2 Inhibition → Decreased synthesis of prostaglandins and thromboxanes.
By blocking prostaglandin production, it reduces inflammation and pain signaling. However, the profound inhibition of constitutive COX-1 also depletes protective prostaglandins in the gastric mucosa and kidneys, leading to its severe ulcerogenic and nephrotoxic side effect profile in small animals.
Seguridad y advertencias
Contraindicaciones
- Active GI ulcers
- History of hypersensitivity to ketorolac
- Pre-existing hematologic, renal, or hepatic disease (relative contraindication)
- Known hypersensitivity to NSAIDs
- Use with extreme caution in patients with deep or progressive corneal ulcers
Efectos adversos
- Gastrointestinal ulceration and erosion
- Gastrointestinal perforation
- Renal toxicity
- Hepatic toxicity
- Platelet inhibition (increased bleeding risk)
- Local ocular irritation
- Delayed corneal epithelial healing
- Increased intraocular pressure (IOP)
- Corneal 'melting' (keratomalacia) - reported in humans, theoretical risk in animals
Precauciones
Use cautiously in patients with a history of GI ulcers, heart failure (may cause fluid retention), and in geriatric patients. Long-term use (>3 days) is not recommended in dogs due to a high tendency to cause gastric erosion and ulcers. Animals suffering from inflammation secondary to concomitant infection should receive appropriate antimicrobial therapy.
Interacciones farmacológicas
Increased risk for nephrotoxicity
Hallucinations reported in some human patients taking with ketorolac
Increased risk for nephrotoxicity
Increased risk for bleeding possible
Increased likelihood of GI adverse effects (blood loss)
May increase risk for GI ulceration
Concomitant administration with NSAIDs may significantly increase the risks for GI adverse effects
May increase risk for nephrotoxicity
May increase NSAID levels
Hallucinations reported in some human patients taking with ketorolac
Ketorolac may reduce the saluretic and diuretic effects of furosemide
Serious toxicity has occurred when NSAIDs have been used concomitantly; use together with extreme caution
Ketorolac may potentiate effects
May cause a significant increase in serum levels and half-life of ketorolac
May lead to increased corneal penetration of the NSAID
Concurrent use is a identified risk factor for precipitating severe corneal problems (e.g., corneal melting)
Monitorización
- Analgesic and anti-inflammatory efficacy
- Gastrointestinal signs (appetite, vomiting, diarrhea, occult blood in feces)
- Renal function parameters (BUN, creatinine, urinalysis) with repeated use
- Intraocular pressure (IOP), especially in predisposed breeds
- Corneal healing via fluorescein staining
- Signs of corneal melting or worsening ulceration
Farmacocinética
Vida media
Absorción
Rapidly absorbed after oral administration; in dogs peak levels occur in about 50 minutes and oral bioavailability is about 50-75%.
Distribución
Distributed marginally through the body. Highly bound to plasma proteins (99%). Volume of distribution in dogs is about 0.33-0.42 L/kg. Crosses the placenta but does not appear to cross the blood-brain barrier.
Metabolismo
Primarily metabolized via glucuronidation and hydroxylation.
Eliminación
Both unchanged drug and metabolites are excreted mainly in the urine. Patients with diminished renal function will have longer elimination times.
Sobredosis
Ketorolac has a narrow margin of safety in small animals.
- Cats: Have developed renal toxicity at doses as low as 0.7 mg/kg.
- Mice: The oral LD50 is 200 mg/kg.
- Clinical Signs: GI effects, including severe GI ulceration and bleeding, are highly likely in overdoses in small animals. Metabolic acidosis has been reported in humans.
- Treatment: Consider GI emptying for large, recent overdoses. Patients must be closely monitored for GI bleeding and renal impairment. Treat aggressively with GI protectants (sucralfate) and consider giving misoprostol early.
Productos disponibles
Formulaciones
- Tablets
- Injection
- Ophthalmic drops: 0.5% solution
Etiquetado para humanos
- Ketorolac Tromethamine Tablets: 10 mg
- Ketorolac Tromethamine Injection: 15 mg/mL & 30 mg/mL in 1 mL, 2 mL single-dose vials, & 10 mL multiple-dose vials
- Acular 0.5% eye drops (5 ml bottle)
Estado regulador
Human authorized product (Acular) used off-label under the cascade.
Human authorized product (Acular) used off-label under the cascade.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store tablets and injection at room temperature and protect from light. Protect tablets from excessive humidity. The injection is stable for at least 48 hours in commonly used IV solutions. It is recommended not to mix the injection with other drugs in the same syringe.
Información para el cliente
Advertencia de seguridad importante: El ketorolaco es un analgésico muy fuerte, pero puede causar úlceras estomacales graves y daño renal en las mascotas si no se utiliza exactamente como se indica.
- Dosificación estricta: Nunca administre este medicamento por más tiempo del recetado (generalmente limitado a un máximo de 1-3 días). No lo administre con mayor frecuencia de la indicada.
- Vigile los efectos secundarios: Suspenda el medicamento inmediatamente y notifique a su veterinario si observa cualquier signo de malestar estomacal, incluyendo pérdida de apetito, vómitos, diarrea, heces negras/alquitranadas o sangre en las heces.
- Cambios de comportamiento: Contacte a su veterinario si su mascota se muestra inusualmente deprimida, letárgica o débil.
- No mezclar: Nunca administre ketorolaco con otros analgésicos (como aspirina, Rimadyl, Metacam o esteroides) a menos que su veterinario se lo indique específicamente.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.