케토롤락

Ketorolac

Ketorolac tromethamine

비스테로이드성 항염증제 (NSAID)POIMIVSCTopical (Ophthalmic)개고양이소형 포유류염소

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

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

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

체중— 🐕

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증	용량	경로	빈도	기간	지역
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.

고양이

적응증	용량	경로	빈도	기간	지역
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.

소형 포유류

적응증	용량	경로	빈도	기간	지역
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

염소

적응증	용량	경로	빈도	기간	지역
As an analgesic	0.3-0.7 mg/kg IV , IM, SC, PO three times daily	IV, IM, SC, PO	three times daily	—	🌎 NA

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

케토롤락(Ketorolac)은 수의학에서 주로 단기 진통 목적으로 사용되는 매우 강력한 비스테로이드성 항염증제(NSAID)입니다.

임상 요점: 케토롤락은 (인의학에서 마약성 진통제와 비교될 정도로) 강력한 진통 효과를 제공하지만, 더 안전한 동물 전용 NSAID가 존재하며 개와 고양이에서 위장관 독성(궤양 및 천공)과 신부전 위험이 매우 높기 때문에 그 사용은 논란의 여지가 있으며 일반적으로 권장되지 않습니다.
개에게 사용할 경우, 대부분의 임상 수의사는 치료 기간을 3일 미만으로 엄격히 제한하며, 미소프로스톨(수크랄페이트 동반 여부 무관)과 같은 위장관 보호제의 병용 투여를 강력히 권장합니다.

작용 기전

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.

안전성·주의사항

금기사항

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

부작용

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

주의

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.

약물 상호작용

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)

모니터링

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

약동학

반감기

개4-8 hours

흡수

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

분포

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.

대사

Primarily metabolized via glucuronidation and hydroxylation.

배설

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

과다투여

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.

제품

제형

Tablets
Injection
Ophthalmic drops: 0.5% solution

인용의약품

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)

규제 현황

European Union✓ 승인됨처방전의약품EMA

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

United Kingdom✓ 승인됨처방전의약품 · POMVMD

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

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

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.

보호자 정보

중요 안전 경고: 케토롤락은 매우 강력한 진통제이지만, 지시대로 정확하게 사용하지 않으면 반려동물에게 심각한 위궤양과 신장 손상을 일으킬 수 있습니다.

엄격한 용량 준수: 처방된 기간(보통 최대 1~3일로 제한)을 초과하여 이 약을 투여하지 마십시오. 지시된 것보다 자주 투여해서는 안 됩니다.
부작용 관찰: 식욕 부진, 구토, 설사, 검고 끈적이는 흑변, 또는 혈변 등 위장 장애의 징후가 보이면 즉시 투약을 중단하고 수의사에게 알리십시오.
행동 변화: 반려동물이 평소와 달리 우울해하거나, 무기력하거나, 쇠약해지면 수의사에게 연락하십시오.
혼합 투여 금지: 수의사의 특별한 지시가 없는 한, 케토롤락을 다른 진통제(아스피린, 리마딜, 메타캄 또는 스테로이드 등)와 함께 투여하지 마십시오.

VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.