ketorolac trometamol + phenylephrine hydrochloride at a glance
Medicine class
An alpha-1 adrenergic agonist combined with a non-steroidal anti-inflammatory drug (NSAID).
Role in surgery
Maintains pupil dilation, prevents pupil constriction and reduces acute eye pain after lens replacement surgery.
How it is given
A surgeon adds the diluted concentrate to fluid used to irrigate the eye during surgery. It is not a take-home eye drop.
Driving
Do not drive or operate machinery until your vision is clear.
What is ketorolac trometamol + phenylephrine hydrochloride used for?
It is licensed for adults undergoing intraocular lens replacement surgery to:
Maintain pupil dilation during surgery.
Prevent the pupil constricting during surgery.
Reduce acute eye pain after surgery.
How does ketorolac trometamol + phenylephrine hydrochloride work?
Phenylephrine stimulates alpha-1 receptors in the iris, widening the pupil. Ketorolac blocks COX-1 and COX-2 enzymes, reducing prostaglandins involved in surgical inflammation, pain and pupil constriction.
How to take ketorolac trometamol + phenylephrine hydrochloride
This product is administered by an appropriately experienced ophthalmic surgeon in a controlled surgical setting.
It must be diluted before intraocular use.
It is added to irrigation solution used during lens replacement surgery.
It is for single use and must not be used undiluted, injected into the vitreous, used as ordinary eye drops or administered systemically.
Follow the surgical team's instructions about other eye drops and postoperative care.
ketorolac trometamol + phenylephrine hydrochloride side effects
Common or expected effects
- Eye pain
- Inflammation in the front of the eye
- Red eye
- Corneal swelling
- Sensitivity to light
- Inflammation
Get urgent medical advice
- Severe or rapidly worsening eye pain after surgery
- Sudden loss or marked worsening of vision
- New flashes, numerous floaters or a curtain-like shadow
- Increasing redness, pain, blurred vision or sticky discharge after surgery
- Breathing difficulty or worsening asthma suggesting NSAID cross-sensitivity
ketorolac trometamol + phenylephrine hydrochloride in pregnancy
Pregnancy data are limited or absent. The product information does not recommend use during pregnancy or in women who could become pregnant and are not using contraception. Discuss pregnancy or plans for pregnancy with the ophthalmic team before surgery.
ketorolac trometamol + phenylephrine hydrochloride while breastfeeding
The product information states that it should not be used while breastfeeding. Discuss alternatives with the specialist team before surgery.
ketorolac trometamol + phenylephrine hydrochloride interactions
Formal interaction studies have not been performed, although systemic exposure during correct surgical use is expected to be minimal and brief.
Opioids
Their pupil-constricting effect may alter how well pupil dilation is maintained.
Non-sedating antihistamines
Their pupil-dilating effect may alter the overall degree of dilation.
Atropine
Combined effects with phenylephrine may increase blood pressure and cause a fast heart rate.
Common questions about ketorolac trometamol + phenylephrine hydrochloride
Answers are fully visible for fast scanning and source review.
Is this an eye drop used at home?
No. It is diluted into surgical irrigation fluid and administered by an ophthalmic surgeon during the operation.
Who must not receive it?
It is contraindicated in people with narrow-angle glaucoma or hypersensitivity to either active ingredient or an excipient.
Can it be used with an aspirin or NSAID allergy?
Particular caution is required because ketorolac may cross-react with aspirin and other NSAIDs, potentially causing bronchospasm or worsening asthma.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.