VetSheet

ケトロラク

Ketorolac

Ketorolac tromethamine

非ステロイド性抗炎症薬 (NSAID)POIMIVSCTopical (Ophthalmic)犬猫小型哺乳類ヤギ

別名: Toradol · Acular · RS-37619-00-31-3 · Ketorolac trometamol

VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス

0.5 mg/kg IV three times daily or 0.3 mg/kg PO twice dailyIV, PO· TID (IV) or BID (PO)· < 3 days
— 🐕

用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

動物種別用量

🌎 NA — North America🌍 EU — Europe

犬

適応用量経路頻度期間地域
As an analgesic0.5 mg/kg IV three times daily or 0.3 mg/kg PO twice dailyIV, POTID (IV) or BID (PO)< 3 days🌎 NA
As an analgesic0.3-0.5 mg/kg IV , IM q8-12h for one or two dosesIV, IMq8-12h1-2 doses🌎 NA
Anterior uveitis and ulcerative keratitis1 drop per eyetopicalq6-24h—🌍 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.

猫

適応用量経路頻度期間地域
As an analgesic0.25 mg/kg IM q8-12h for one or two dosesIMq8-12h1-2 doses🌎 NA
Anterior uveitis and ulcerative keratitis1 drop per eyetopicalq6-24h—🌍 EU
  • Anterior uveitis and ulcerative keratitis: Frequency depends on the severity of inflammation.

小型哺乳類

適応用量経路頻度期間地域
As an analgesic (Mice)0.7-10 mg/kg PO once dailyPOonce daily—🌎 NA
As an analgesic (Rats)3-5 mg/kg PO once to twice a day; 1 mg/kg IM once to twice a dayPO, IMonce to twice a day—🌎 NA

ヤギ

適応用量経路頻度期間地域
As an analgesic0.3-0.7 mg/kg IV , IM, SC, PO three times dailyIV, IM, SC, POthree times daily—🌎 NA

用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

診察中ですか？VetSheet の AI が薬剤・用量・投与期間を構造化された診察記録に直接記入します。VetSheet の仕組みを見る

概要

​ケトロラク​は、獣医学において主に短期的な鎮痛に使用される非常に強力な非ステロイド性抗炎症薬（NSAID）です。

  • ​臨床上のポイント​: ケトロラクは強力な鎮痛効果（ヒト医療ではオピオイドと比較されることが多い）を提供しますが、より安全な動物用NSAIDが利用可能であること、および犬や猫において​胃腸毒性​（潰瘍や穿孔）や​腎毒性​のリスクが非常に高いため、その使用は議論の余地があり、一般的には推奨されません。
  • 犬に使用する場合、ほとんどの臨床医は治療を​3日未満​に厳しく制限し、​ミソプロストール​（スクラルファートの併用を問わず）などの胃腸保護薬の同時投与を強く推奨します。

作用機序

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.

安全性・警告

禁忌

  • 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

有害事象

  • 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

注意事項

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.

医薬品相互作用

ACE INHIBITORS

Increased risk for nephrotoxicity

ALPRAZOLAM

Hallucinations reported in some human patients taking with ketorolac

AMINOGLYCOSIDES (gentamicin, amikacin, etc.)

Increased risk for nephrotoxicity

ANTICOAGULANTS (heparin, LMWH, warfarin)

Increased risk for bleeding possible

ASPIRIN

Increased likelihood of GI adverse effects (blood loss)

BISPHOSPHONATES (alendronate, etc.)

May increase risk for GI ulceration

CORTICOSTEROIDS

Concomitant administration with NSAIDs may significantly increase the risks for GI adverse effects

CYCLOSPORINE

May increase risk for nephrotoxicity

FLUCONAZOLE

May increase NSAID levels

FLUOXETINE

Hallucinations reported in some human patients taking with ketorolac

FUROSEMIDE

Ketorolac may reduce the saluretic and diuretic effects of furosemide

METHOTREXATE

Serious toxicity has occurred when NSAIDs have been used concomitantly; use together with extreme caution

MUSCLE RELAXANTS, NONDEPOLARIZING

Ketorolac may potentiate effects

PROBENECID

May cause a significant increase in serum levels and half-life of ketorolac

Gentamicin (and other drugs affecting corneal epithelium)Moderate

May lead to increased corneal penetration of the NSAID

Topical corticosteroidsMajor

Concurrent use is a identified risk factor for precipitating severe corneal problems (e.g., corneal melting)

監視

  • 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

薬物動態

半減期

犬4-8 hours

吸収

Rapidly absorbed after oral administration; in dogs peak levels occur in about 50 minutes and oral bioavailability is about 50-75%.

分布

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.

代謝

Primarily metabolized via glucuronidation and hydroxylation.

消失

Both unchanged drug and metabolites are excreted mainly in the urine. Patients with diminished renal function will have longer elimination times.

過剰投与

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.

製品

製剤

  • Tablets
  • Injection
  • Ophthalmic drops: 0.5% solution

ヒト用医薬品

  • 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)

規制ステータス

European Union✓ 承認済み処方箋医薬品EMA

Human authorized product (Acular) used off-label under the cascade.

United Kingdom✓ 承認済み処方箋医薬品 · POMVMD

Human authorized product (Acular) used off-label under the cascade.

規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

保管・安定性

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.

飼主向け情報

​重要な安全上の警告​: ケトロラクは非常に強力な鎮痛薬ですが、指示通りに正確に使用しないと、ペットに重篤な胃潰瘍や腎臓の損傷を引き起こす可能性があります。

  • ​厳格な用量遵守​: 処方された日数（通常は最大1〜3日に制限されます）を超えてこの薬を与えないでください。指示された以上に頻繁に与えないでください。
  • ​副作用への注意​: 食欲不振、嘔吐、下痢、​黒色/タール状の便​、血便など、胃腸の不調の兆候が見られた場合は、直ちに投薬を中止し、獣医師に連絡してください。
  • ​行動の変化​: ペットが異常に落ち込んだり、無気力になったり、弱ったりした場合は、獣医師に連絡してください。
  • ​他の薬との併用禁止​: 獣医師の特別な指示がない限り、ケトロラクを他の鎮痛薬（アスピリン、リマダイル、メタカム、ステロイドなど）と一緒に与えないでください。

VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。