Ketorolac eye drop is a non-steroidal anti-inflammatory drug (NSAID). It's used to treat inflammation and pain after corneal or cataract surgery. Ketorolac eye drop can also help with itchy eyes from allergies, but it's not a first-choice medication for this condition. Ketorolac eye drop can be used by adults and children and is typically instilled 2 to 4 times per day, depending on the medical condition. Some common side effects include stinging, burning, and irritation after putting the eye drops. Ketorolac eye drop is available as a generic and as brand name medications (Acular, Acular LS, and Acuvail).
Relief of pain or inflammation after cornea refractive surgery in people ages 3 years and older - Ketorolac (Acular LS) 0.4% only
Relief of pain or inflammation after cataract removal in people ages 2 years and older- Ketorolac (Acuvail) 0.45% and ketorolac (Acular) 0.5% only
Itchy eyes due to allergies in people ages 2 years and older - Ketorolac (Acular) 0.5% only
Ketorolac eye drop is a non-steroidal anti-inflammatory drug (NSAID) eye drop. It works by blocking a protein (called cyclooxygenase, or COX) in your eye that makes chemicals that cause inflammation, pain, and swelling.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Itching, redness, tearing, or other sign of eye irritation not present before use of this medicine or becoming worse during use
redness of the clear part of the eye
sensitivity to light
swelling of the eye
swelling of the eyelids
tearing
throbbing pain
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Stinging or burning of the eye when medicine is applied
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Works well for eye pain, inflammation, and itching
Causes fewer serious side effects than oral ketorolac
Both ketorolac 0.4% and 0.5% strengths are available as lower-cost generics.
A possible option for children
Can cause temporary stinging or burning after using
Need to use 2 to 4 times a day
Might not be safe if you're allergic to NSAIDs or aspirin
Requires removal of soft contact lenses
Before starting this medication, make sure a healthcare professional teaches you how to give yourself ketorolac eye drop so that you avoid accidentally hurting yourself or wasting the medication. Carefully read on how to give yourself the eye drops. Contact your prescriber or pharmacist if you have any questions.
Wash your hands before putting ketorolac eye drop in your eyes. Don't touch the dropper tip with your eye, hands, or any other surface. This will help you avoid eye infections by preventing contamination of the solution.
Once you're ready to place the drops, tilt your head back and look up. Then, pull your lower eyelid down to form a pocket with one hand. Take the ketorolac eye drop bottle and give yourself a drop using the other hand. After, close your eye and press one finger to the inner corner of your eye by the nose and press lightly for 1 minute.
Use ketorolac eye drop exactly as prescribed. If you're preparing for eye surgery, timing of medication eye drops is very important, so make sure you know when to start taking it. Don't take ketorolac eye drop for more than 2 weeks following cataract surgery, or more than 4 days after cornea surgery, unless your prescriber tells you to do so.
If you need to use multiple different eye products in the same eye, separate each eye product from ketorolac eye drop by at least 5 minutes. This makes sure your eye(s) absorb each medication fully.
If you wear contact lenses, take them out before using ketorolac eye drop so your eye(s) can absorb all of the medication. Your eye specialist might instruct you to wait at least 15 minutes before putting your lenses back into your eye(s).
Store ketorolac eye drop at room temperature in the original bottle it came in from the pharmacy.
If you're pregnant, tell your healthcare team before using ketorolac eye drop. You should avoid using ketorolac eye drop if you are late in your pregnancy, since the medication might affect the health of your child.
Ketorolac eye drop can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Also using corticosteroid eye drops
Ketorolac eye drop can slow down the healing process, especially if you're also using corticosteroid eye drops, such as prednisolone or dexamethasone. Make sure to attend your follow-up appointments so your eye specialist can monitor your healing progress.
Risk factors: History of allergy to aspirin, NSAIDs, or similar medications | History of asthma
Though very rare, ketorolac eye drop might trigger trouble breathing or an asthma flare-up, especially in people who have a history of these types of reactions from taking aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs). Let your prescriber know if you've had a history of breathing problems or allergies to these types of medications. Seek medical help immediately if you experience difficulty breathing after starting ketorolac eye drop.
Risk factors: History of bleeding problems | Using other medications that raise your risk of bleeding
Ketorolac eye drop can raise your risk of bleeding after eye surgery. Let your prescriber know if you have a history of bleeding problems or if you take any medications, such as blood thinners, that can make you more likely to bleed. Call your prescriber if you notice blood spots on your eye, especially if you just had eye surgery.
Risk factors: History of problems with the cornea or surface of the eye | Multiple eye surgeries | Rheumatoid arthritis | Diabetes | Using ketorolac eye drop for a long time
Ketorolac eye drop can cause inflammation (called keratitis), weakening, or injury to the cornea, which is the outermost, clear layer of the eye. These problems can affect your eyesight. Let your prescriber know if you've had cornea problems or multiple eye surgeries in the past. Make sure you're getting regular eye check-ups while you're using ketorolac eye drop. Contact your optometrist or ophthalmologist immediately if you notice changes in your vision or more eye pain or discomfort. Use ketorolac eye drop exactly as prescribed, and do not use it for longer after surgery than prescribed.
If you wear contact lenses, take them out each time before you place ketorolac eye drop into your eye(s). Ask your prescriber when it's safe for you to put the contacts back in your eye(s).
Pain after cornea surgery:
Ketorolac (Acular LS) 0.4% only: The typical dose is to place 1 drop in the affected eye(s) 4 times a day as needed for up to 4 days after surgery.
Pain or inflammation after cataract surgery:
Acuvail (ketorolac) 0.45%: The typical dose is to place 1 drop in the affected eye(s) 2 times a day starting 1 day before surgery. Continue using the drops on the day of your surgery and for 2 weeks after surgery.
Ketorolac (Acular) 0.5%: The typical dose is place 1 drop in affected eye(s) 4 times a day starting 24 hours after surgery and continue for 2 weeks after.
Allergy-related itchy eyes:
Ketorolac (Acular) 0.5%: The typical dose is to place 1 drop in the affected eye(s) 4 times a day.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.
Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Relief of pain or inflammation after cornea refractive surgery in people ages 3 years and older - Ketorolac (Acular LS) 0.4% only
Relief of pain or inflammation after cataract removal in people ages 2 years and older- Ketorolac (Acuvail) 0.45% and ketorolac (Acular) 0.5% only
Itchy eyes due to allergies in people ages 2 years and older - Ketorolac (Acular) 0.5% only
Eye pain and eye inflammation after cataract surgery in adults
Relief of eye pain and inflammation after cataract removal surgery for people ages 10 years and older
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Apotex Corp. (2023). Ketorolac tromethamine solution/ drops [package insert]. DailyMed.
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SafeMedication. (n.d.). How to use eye drops.
Turbert, D., et al. (2023). What is refractive surgery? American Academy of Ophthalmology.
Vaajanen, A., et al. (2017). A single drop in the eye - Effects on the whole body? The Open Ophthalmology Journal.
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