In the US, ketorolac is the only widely available intravenous NSAID. An IV form of paracetemol, which is not an NSAID, became available in Europe in 2009 and then in the US.[13]

The Syntex company, of Palo Alto, California developed the ophthalmic solution Acular around 2006.[citation needed]

In 2007, there were concerns about the high incidence of reported side effects. This led to restriction in its dosage and maximum duration of use. In the UK, treatment was initiated only in a hospital, although this was not designed to exclude its use in prehospital care and mountain rescue settings.[7] Dosing guidelines were published at that time.[22]

Concerns over the high incidence of reported side effects with ketorolac trometamol led to its withdrawal (apart from the ophthalmic formulation) in several countries, while in others its permitted dosage and maximum duration of treatment have been reduced. From 1990 to 1993, 97 reactions with a fatal outcome were reported worldwide.[23]

The eye-drop formulation was approved by the FDA in 1992.[24]

An intranasal formulation was approved by the FDA in 2010[25] for short-term management of moderate to moderately severe pain requiring analgesia at the opioid level.


  1. Jump up to:a b c d e f g h i “Ketorolac Tromethamine Monograph for Professionals”Drugs.com. American Society of Health-System Pharmacists. Retrieved 13 April 2019.
  2. Jump up to:a b c d British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. pp. 1144, 1302–1303. ISBN 9780857113382.
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  8. Jump up to:a b c d e f g h i Vallerand AH (2017). Davis’s Drug Guide for Nurses. Philadelphia: F.A. Davis Company. p. 730. ISBN 9780803657052.
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  12. ^ Henry, p. 280.
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  18. ^ Sivaprasad S, Bunce C, Crosby-Nwaobi R (February 2012). “Non-steroidal anti-inflammatory agents for treating cystoid macular oedema following cataract surgery”. The Cochrane Database of Systematic Reviews (2): CD004239. doi:10.1002/14651858.CD004239.pub3PMID 22336801.
  19. ^ Wakai A, Lawrenson JG, Lawrenson AL, Wang Y, Brown MD, Quirke M, et al. (May 2017). “Topical non-steroidal anti-inflammatory drugs for analgesia in traumatic corneal abrasions”The Cochrane Database of Systematic Reviews5: CD009781. doi:10.1002/14651858.CD009781.pub2PMC 6481688PMID 28516471.
  20. Jump up to:a b Henry, p. 279.
  21. ^ Lee IO, Seo Y (March 2008). “The effects of intrathecal cyclooxygenase-1, cyclooxygenase-2, or nonselective inhibitors on pain behavior and spinal Fos-like immunoreactivity”. Anesthesia and Analgesia106 (3): 972–7, table of contents. doi:10.1213/ane.0b013e318163f602PMID 18292448.
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