Ketorolak
Klassificering: AATC kod: M01AB15
Sammanfattning
Ingen skillnad i effekt av ketorolak mellan könen kunde påvisas i en experimentell smärtmodell.
Kunskapsunderlaget avseende skillnader mellan kvinnor och män är begränsat och motiverar inte olika dosering eller behandling.
Additional information
Pharmacokinetics and dosing
No studies with a clinically relevant sex analysis regarding the pharmacokinetics or dosing of ketorolac have been found.
Effects
The analgesic efficacy of ketorolac (10 mg p.o.) was evaluated in an experimental pain method using cold pressor test (25 men, 25 women). No difference between men and women in ketorolac response was found [1].
Adverse effects
A case-control study (136 men, 130 women) found an association between NSAID exposure and liver injury in women but not in men (6.49 vs. 1.06). This may be due to differences in pharmacokinetics or levels of circulating hormones and/or more poly-pharmacy in women [2] or to a generally higher risk of drug-induced liver injury in women [3]. If this is an adverse effect for NSAIDs in general or only associated with certain NSAIDs is unclear. If ketorolac was included is not specified.
A meta-analysis evaluated NSAID use and the risk of Parkinson’s disease. Pooled risk ratio of Parkinson’s disease were similar in men and women using NSAID (men 0.79; women 0.72) [4]. If this is an effect for NSAIDs in general or only associated with certain NSAIDs is unclear. If ketorolac was included is not specified.
Reproductive health issues
Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).
Försäljning på recept
Injektionsvätska innehållande ketorolak (ATC-kod M01AB15) används huvudsakligen på sjukhus och därför saknas könsspecifika användningsdata [5].
Uppdaterat: 2019-02-26
Litteratursökningsdatum: 2015-01-26
Referenser
- Compton P, Charuvastra VC, Ling W. Effect of oral ketorolac and gender on human cold pressor pain tolerance. Clin Exp Pharmacol Physiol. 2003;30:759-63. PubMed
- Lacroix I, Lapeyre-Mestre M, Bagheri H, Pathak A, Montastruc JL, Club de Reflexion des cabinets de Groupe de Gastro-Enterologie (CREGG) et al. Nonsteroidal anti-inflammatory drug-induced liver injury: a case-control study in primary care. Fundam Clin Pharmacol. 2004;18:201-6. PubMed
- Leise MD, Poterucha JJ, Talwalkar JA. Drug-induced liver injury. Mayo Clin Proc. 2014;89:95-106. PubMed
- Samii A, Etminan M, Wiens MO, Jafari S. NSAID use and the risk of Parkinson's disease: systematic review and meta-analysis of observational studies. Drugs Aging. 2009;26:769-79. PubMed
- Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2015 [cited 2016-04-05.] länk
Faktagranskat av: Mia von Euler
Godkänt av: Karin Schenck-Gustafsson