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Ketorolac trometamol ocular

Updated 2 Feb 2023 | Ocular peri-operative drugs


Eye drops containing ketorolac trometamol (preservative containing).

Drugs List

  • ACULAR 0.5% eye drops
  • ketorolac 0.5% eye drops
  • Therapeutic Indications


    Topical prophylaxis and treatment of inflammation after ocular surgery



    Instil 1 drop into the affected eye(s) three times a day starting 24 hours pre-operatively and continuing for up to 21 days post-operatively.


    Corneal epithelial breakdown

    Precautions and Warnings

    Children under 18 years
    Haemorrhagic diathesis
    Soft contact lenses
    Corneal damage
    Corneal disorder
    Diabetes mellitus
    Dry eyes
    Ocular infection
    Rheumatoid arthritis

    May mask symptoms or signs of infections
    Advise patient blurred vision may affect ability to drive/operate machinery
    Contains benzalkonium chloride. Not to be used with soft contact lenses
    In combined therapy, administer eye products at least five minutes apart
    To reduce systemic absorption compress lacrimal sac during administration
    Monitor for, and discontinue in, corneal epithelial breakdown
    Monitor patients for development of keratitis
    May prolong bleeding time
    Advise patient to avoid touching the eye/other surfaces with container tip
    If soft contact lenses worn,insert them 15 minutes after using eye drops

    This medication should be used with caution in patients with complicated ocular surgeries, corneal denervation, corneal epithelial defects, diabetes mellitus, ocular surface diseases (for example, dry eye syndrome), rheumatoid arthritis, or repeat ocular surgeries within a short period of time, as they may be at increased risk for corneal adverse events which may become sight threatening.

    Pregnancy and Lactation


    Ketorolac trometamol is contraindicated during pregnancy.

    The manufacturer does not recommend ketorolac trometamol during pregnancy. Available studies have shown teratogenic effects including cardiac defects, orofacial clefts and spontaneous abortions following the use of ketorolac trometamol during pregnancy. Some studies suggested there was most risk of teratogenic effects in the 1st and 3rd trimesters (Briggs 2015).


    Ketorolac trometamol is contraindicated during breastfeeding.

    The manufacturer states ketorolac trometamol eye drops should not be used during breastfeeding. Whilst available data shows ketorolac trometamol is present in breast milk, the amount was considered insignificant (Briggs 2015). Studies on lactation whilst using ketorolac trometamol are limited but there is no evidence of negative impact on ability to breastfeed (Lactmed 2022).

    Side Effects

    Blurred vision
    Blurred vision (transient)
    Conjunctival hyperaemia
    Corneal erosion
    Corneal infiltrates
    Corneal perforation
    Corneal thinning
    Corneal ulcer
    Dryness of eyes
    Epithelial damage
    Eye pain
    Eyelid oedema
    Hypersensitivity reactions
    Impaired vision
    Ocular burning
    Ocular irritation
    Ocular oedema
    Ocular pruritus
    Superficial punctate keratitis


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: July 2022

    Reference Sources

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

    Summary of Product Characteristics: Acular, AbbVie Ltd, revised April 2022.

    NICE Evidence Services Available at: Last accessed: 22 July 2022

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Ketorolac Last revised: April 2022
    Last accessed: July 2022

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