Ketorolac tromethamine
Anti-inflammatory · Rx
Trade namesAcular, Acular LS, Acuvail (PF)
Drug classTopical NSAID
Strength0.4%, 0.45%, 0.5%
AvailabilityRx
Mechanism of actionNon-selective cyclo-oxygenase inhibitor; blocks prostaglandin synthesis, reducing inflammation, pain and miosis without steroid liabilities.
Indication / reason for usePost-op inflammation and pain after cataract surgery; prophylaxis/treatment of cystoid macular edema; seasonal allergic conjunctivitis itching; pain relief in corneal abrasion / post-PRK.
Usual adult dosing1 drop 2-4×/day depending on formulation; Acuvail BID.
PreservativeBAK (Acular); Acuvail is preservative-free , a preservative-free option exists
Contact lensesRemove lenses before instillation; some clinicians use a PF NSAID under a bandage lens post-PRK, specialist context only.
Common / important adverse effectsStinging/burning on instillation, conjunctival hyperemia; rare corneal melt / persistent epithelial defect with prolonged use or in at-risk corneas.
Contraindications & cautionsLate-pregnancy use (see below); caution with corneal denervation, ocular surface disease, diabetes, rheumatoid arthritis, repeat ocular surgery, concurrent topical steroids, all raise melt risk. Aspirin/NSAID hypersensitivity.
Pregnancy / lactationAvoid in the third trimester (prostaglandin inhibition, premature ductus arteriosus closure risk); minimal but nonzero systemic absorption.
Practice notesEffective non-narcotic analgesia for corneal abrasion; limit duration and review the epithelium.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.