- Moderately severe acute pain:
- IV 30mg *1 OR 30mg QID. Max 120mg/day
- IM 60mg *1 OR 30mg QID. Max 120 mg/day
- PO 20mg *1 after IV/IM therapy, then 10mg every 4-6 hours. Max 40mg/day
- Migraine-associated pain (Off-label):
- IV 30mg *1 OR IM 60mg *1
- Tablet:
- 10mg
- Injection:
- 30mg/mL
- 10mg/mL
IV should be injected over 15 seconds
NSAID
It reduces production of prostaglandin precursors by inhibiting COX-1 and COX-2
- Headache
- Nausea
- Abdominal pain
- Dyspepsia
- Dizziness
- Somnolence
- Constipation
- Diarrhea
- Edema
- Rash
- Elevated ALT/AST
- Fluid retention
- Tinnitus
- Injection site pain
- Hypertension
- Pruritus
- Flatulence
- Diaphoresis
- Ecchymosis
- Photosensitivity
- Delayed ovulation
- Hypersensitivity to class/components
- Aspirin or NSAID-induced asthma
- Aspirin or NSAID-induced urticaria
- Aspirin triad
- Epidural use
- Intrathecal use
- CABG surgery peri-op use
- Major surgery pre-op use
- Advanced renal impairment
- Coagulation disorder
- Active bleeding
- GI bleeding history
- PUD history
- Cerebrovascular hemorrhage
- Volume depletion
- Pregnancy starting at 30 week gestation
- Labor and delivery
WARNING
- For short term (up to 5 days in adults) treatment of moderately severe acute pain requiring opioid-level analgesia and only as continuation of parenteral treatment
- Total combined duration should NOT exceed 5 days
- NOT indicated for minor or chronic pain
- Oral treatment not indicated in children
- Max recommended total daily dose: PO 40mg and IV/IM 120mg
- Serious GI adverse event risk, including bleeding, ulcer and stomach or intestine perforation, which can be fatal
- NSAIDs increase risk of serious and potentially fatal cardiovascular thrombotic events, including MI and stroke
- Risk may occur early in treatment and may increase with duration of use
- May adversely affect fetal circulation and inhibit uterine contractions
- Max total daily dose 60mg IV/IM in patients >65 years if weight <50 kg, or moderately elevated Cr
- Max single dose IM 30mg and IV 15mg in pedriatric patients
- Aspirin
- Celecoxib
- Diclofenac
- Diflunisal
- Etodolac
- Fenoprofen
- Flurbiprofen
- Ibuprofen
- Ketoprofen
- Ketorolac
- Magnesium salicylate
- Meclofenamate
- Mefenamic acid
- Meloxicam
- Nabumetone
- Naproxen
- Oxaprozin
- Pentoxifylline
- Piroxicam
- Probenecid
- Salsalate
- Sulindac
- Tolmetin
Drug Status
| Availability | Prescription or OTC by Pharmacist |
| Pregnancy | Category D |
| Breastfeeding | Contraindicated |
| Schedule | Not controlled |
| BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
|---|---|---|---|---|---|
| Biorolac | 30mg/mL | Injection | 5’s | Clinica Ltd | Bio-labs Ltd |
| Dolac | 30mg/mL | Injection | 10’s | Cadila Pharm | Cadila Pharm |
| Dolac | 10mg | Tablet | 10’s | Cadila Pharm | Cadila Pharm |
| Ketogress | 10mg | Tablet | 10’s | La Renon | Wessex Pharma |
| Rolac | 10mg | Tablet | 20’s | Renata Ltd | Harley’s Ltd |
| Rolac | 30mg/mL | Injection | 6’s | Renata Ltd | Harley’s Ltd |
| Rolac | 10mg/mL | Injection | 20’s | Renata Ltd | Harley’s Ltd |