Where is toradol metabolized

Ketorolac is extensively metabolised through glucuronidation and oxidation; little if any drug is eliminated unchanged. Most of the dose of ketorolac is recovered in the urine as conjugated drug. Although ketorolac is excreted into the breast milk, the amount of drug transferred comprises only a small fraction of the maternal exposure. Little stereoselectivity was present in the pharmacokinetics of ketorolac in a healthy volunteer receiving single intravenous or oral doses.

The elderly exhibit reduced clearance of the drug. Renal insufficiency appears to cause an accumulation of ketorolac in plasma, although hepatic disease may not affect the pharmacokinetics. For patients age 65 and older, renally impaired patients, and those who weigh less than 50 kg lb , 10 mg P.

Pharmacokinetics Absorption: I. Contraindications and precautions Contraindicated in patients hypersensitive to drug and those with active peptic ulcer disease, recent GI bleeding or perforation, advanced renal impairment, risk of renal impairment because of volume depletion, suspected or confirmed cerebrovascular bleeding, hemorrhagic diathesis, incomplete hemostasis, or high risk of bleeding. Also contraindicated in patients with history of peptic ulcer disease or GI bleeding, past allergic reactions to aspirin or other NSAIDs, and during labor and delivery or breast-feeding.

In addition, drug is contraindicated as prophylactic analgesic before major surgery or intraoperatively when hemostasis is critical; in patients receiving aspirin, an NSAID, or probenecid; and in those requiring analgesics to be administered epidurally or intrathecally.

Use cautiously in patients with impaired renal or hepatic function. Interactions Drug-drug. Diuretics: Decreases diuretic efficacy and increases risk of nephrotoxicity.

Monitor patient closely. Lithium: Decreases renal clearance of lithium, increasing lithium levels and risk of lithium toxicity. Avoid use together, if possible. If given together, closely monitor lithium levels. Methotrexate: Elevates and prolongs methotrexate levels, possibly leading to toxicity. Avoid use together. Probenecid: Decreases clearance and increases levels of ketorolac. Salicylates, warfarin: Increases blood levels of these drugs.

Use with extreme caution; monitor patient closely. Alcohol use: Increases GI effects, including ulceration and hemorrhage.