Solution for injections of Ambit is shown for:

• Stopping of a moderate and severe postoperative acute pain during short time.
Treatment should be begun with
• only in hospitals. The maximum duration of treatment – 2 days.

Structure

Active ingredient: ketorolac;

1 ml of solution;

Excipients: ethanol of 96%, sodium chloride, Acidum hydrochloricum diluted sodium hydroxide, water for injections.

Ketorolak is contraindicated to

Contraindication

• to patients at whom reactions of hypersensitivity to the ketorolak any of excipients or other NPVS were observed earlier and patients with allergic reactions to aspirin, or other inhibitors of synthesis of prostaglandins in the anamnesis (at such patients heavy anaphylactic reactions were observed). Such reactions included asthma, rhinitis, a Quincke's disease or a small tortoiseshell;
• to patients with bronchial asthma in the anamnesis;
• to children up to 16 years;
• to patients with an active round ulcer, with recent gastrointestinal bleeding, a peptic ulcer or perforation;
• as well as other NPVS, to patients with heavy heart failure, a liver failure and a renal failure;
• to patients with a moderate or heavy renal failure (creatinine level in blood serum more than 160 µmol/l) or to patients with risk of developing a renal failure owing to reduction of volume of liquid or dehydration;
• during pregnancy, during the fights and childbirth, during feeding by a breast;
• as preventive anesthetic before operation because of suppression of aggregation of platelets and during operation because of the increased risk of bleeding;
• because of oppression of function of platelets to patients with suspicion or the confirmed cerebrovascular bleeding, to patients with high risk of bleeding or an incomplete stop of bleeding and also to patients with high risk of bleedings, such as hemorrhagic diathesis, including coagulation violations;
• to the patients receiving anticoagulants including warfarin and low doses of heparin (2500‑5000 units each 12 hours);
• at simultaneous treatment by acetylsalicylic acid or other NPVS (including selection inhibitors of cyclooxygenase-2);
• for neuroaxial (epidural or intrathecal) introductions because of alcohol content;
• in a combination with okspentifiliny;
• simultaneous treatment with probenetsidy or lithium salts;
• to patients with a full or partial syndrome of nasal polyps, a Quincke's disease or a bronchospasm.

by

for an intramuscular or bolyusny intravenous injection. Bolyusny intravenous doses should be entered within not less than 15 seconds. Ketorolak it is not necessary to apply to epidural or spinal introduction.

Time of the beginning of analgesic effect after injections is similar to

and is about 30 minutes with its maximum intensity within 1–2 hours. The average duration of an analgesia is 4–6 hours.

Selection and dose adjustment should be carried out by

according to intensity of pain and response to medicine introduction.

to

Feature of application

Pregnant

Due to the proved influence of NPVS on the cardiovascular system of a fruit (early closing of an arterial channel), ketorolak it is contraindicated during pregnancy, fights or childbirth.

by

. Therefore ketorolak children are not recommended to apply up to 16 years.

by

Drivers

At some patients the dizziness, drowsiness, fatigue, a disorder of vision, a headache, vertigo, insomnia or a depression after application of a ketorolak can be observed. If such frustration are observed, patients should not steer vehicles or to work with mechanisms.

Overdose

Symptoms. The one-time overdose ketorolaky at different times led to an abdominal pain, nausea, vomiting, a hyperventilation, round ulcers and/or erosive gastritis and a renal failure which passed after medicament withdrawal.

Treatment. Patients have to receive the symptomatic treatment and treatment supporting the vital functions after overdose of NPVS. Special antidote does not exist. Dialysis does not lead to significant removal of a ketorolak from blood because of high linking with proteins.

within the first hour, it is possible to use activated carbon or gastric lavage as therapy of adult patients at threat of life.

Besides, it is necessary to provide the corresponding diuresis. Also it is necessary to carry out monitoring of function of a liver and kidneys, the patient has to be under observation within at least 4 hours after reception of such amount of medicine which can cause toxicity. When developing repeated or long spasms it is necessary to use diazepam. Application of other therapeutic actions depending on a clinical condition of the patient is also possible.

Side effects

General violations and complications in the injection site of medicine. Excessive thirst, an adynamy, hypostases, reactions and pain in the place of an injection, fever, a stethalgia.

Also noted an indisposition, increased fatigue and increase in body weight.

Laboratory researches. The extended bleeding time, the increased urea level in blood serum, the increased creatinine level, violation of functional trials of a liver.

Interaction

Ketorolak substantially contacts proteins of blood plasma (on average for 99.2%) and his binding depends on concentration.

At simultaneous introduction of a ketorolak and okspentifilin the increased tendency to bleeding exists.

to Store

in original packing. Does not demand special storage conditions. To store out of children's reach.

Expiration date - 2 years.