{"id":57860,"date":"2024-02-27T18:05:01","date_gmt":"2024-02-27T18:05:01","guid":{"rendered":"https:\/\/medsname.com\/ketorol-dt\/"},"modified":"2026-05-01T10:49:14","modified_gmt":"2026-05-01T10:49:14","slug":"ketorol-dt","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/ketorol-dt\/","title":{"rendered":"Ketorol DT"},"content":{"rendered":"

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\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Ketorol DT?<\/h3>\n

Ketorol DT<\/strong> je ketorolak trometamol 10 mg or\u00e1ln\u011b dispergovateln\u00e1 tableta<\/strong> po dobu kr\u00e1tkodob\u00e1<\/strong> \u00faleva od st\u0159edn\u011b siln\u00e9 a\u017e siln\u00e9 akutn\u00ed bolesti. Ketorolak je neobvykle \u00fa\u010dinn\u00fd mezi peror\u00e1ln\u00edmi NSAID a \u010dasto se pou\u017e\u00edv\u00e1 jako neopioidn\u00ed analgetikum<\/strong> po chirurgick\u00fdch z\u00e1kroc\u00edch, stomatologick\u00fdch v\u00fdkonech, ren\u00e1ln\u00ed kolice nebo p\u0159i v\u00fdrazn\u00e9m poran\u011bn\u00ed m\u011bkk\u00fdch tk\u00e1n\u00ed. Obvykl\u00e1 d\u00e1vka: 10 mg ka\u017ed\u00fdch 4\u20136 hodin s j\u00eddlem, maxim\u00e1ln\u011b po dobu 5 dn\u016f<\/strong>. Kv\u016fli riziku gastrointestin\u00e1ln\u00edch a ren\u00e1ln\u00edch komplikac\u00ed se ketorolak nikdy nepou\u017e\u00edv\u00e1 dlouhodob\u011b<\/strong> \u2014 jde pouze o kr\u00e1tkodob\u011b u\u017e\u00edvan\u00fd l\u00e9k.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n

Ketorol DT<\/strong> je or\u00e1ln\u011b dispergovateln\u00e1 tableta (DT) obsahuj\u00edc\u00ed ketorolak trometamol 10 mg<\/strong> \u2014 jedin\u00e9 NSAID na sv\u011bt\u011b ur\u010den\u00e9 v\u00fdhradn\u011b pro kr\u00e1tkodobou \u00falevu od siln\u00e9 bolesti. Analgetick\u00fd \u00fa\u010dinek ketorolaku je srovnateln\u00fd s n\u00edzk\u00fdmi d\u00e1vkami morfinu p\u0159i st\u0159edn\u011b siln\u00e9 bolesti, co\u017e mu d\u00e1v\u00e1 zvl\u00e1\u0161tn\u00ed m\u00edsto v poopera\u010dn\u00ed p\u00e9\u010di, po stomatologick\u00fdch v\u00fdkonech a p\u0159i ren\u00e1ln\u00ed kolice, kde je pot\u0159eba siln\u00e1 analgezie bez sedace, deprese d\u00fdch\u00e1n\u00ed nebo rizika vzniku z\u00e1vislosti jako u opioid\u016f.<\/p>\n

Or\u00e1ln\u011b dispergovateln\u00e1 forma se rozpou\u0161t\u00ed na jazyku b\u011bhem n\u011bkolika vte\u0159in, co\u017e je u\u017eite\u010dn\u00e9 p\u0159i obt\u00ed\u017e\u00edch s polyk\u00e1n\u00edm tablet \u2014 poopera\u010dn\u00ed nevolnost, ned\u00e1vn\u00fd stomatologick\u00fd z\u00e1krok nebo siln\u00e9 zvracen\u00ed.<\/p>\n

K \u010demu se Ketorol DT pou\u017e\u00edv\u00e1?<\/h2>\n
    \n
  • Kr\u00e1tkodob\u00e1 l\u00e9\u010dba st\u0159edn\u011b siln\u00e9 a\u017e siln\u00e9 akutn\u00ed bolesti<\/strong> \u2014 poopera\u010dn\u00ed, poporodn\u00ed, po zubn\u00edch z\u00e1kroc\u00edch<\/li>\n
  • Ledvinov\u00e1 kolika<\/strong> (bolest p\u0159i ledvinov\u00fdch kamenech) \u2014 ketorolak je v mnoha studi\u00edch stejn\u011b \u00fa\u010dinn\u00fd jako parenter\u00e1ln\u00ed opioidy<\/li>\n
  • Bili\u00e1rn\u00ed kolika<\/strong><\/li>\n
  • Akutn\u00ed poran\u011bn\u00ed pohybov\u00e9ho apar\u00e1tu<\/strong> \u2014 t\u011b\u017ek\u00e9 poran\u011bn\u00ed m\u011bkk\u00fdch tk\u00e1n\u00ed<\/li>\n
  • Prim\u00e1rn\u00ed dysmenorea<\/strong> \u2014 siln\u00e1 menstrua\u010dn\u00ed bolest nereaguj\u00edc\u00ed na NSAID prvn\u00ed volby<\/li>\n
  • Akutn\u00ed migr\u00e9na<\/strong> \u2014 druh\u00e1 volba; zejm\u00e9na kdy\u017e jsou triptany kontraindikov\u00e1ny<\/li>\n<\/ul>\n

    Ketorolak nen\u00ed indikov\u00e1n pro m\u00edrnou nebo chronickou bolest<\/strong>. Jeho pou\u017eit\u00ed u stav\u016f, kde by posta\u010doval paracetamol nebo ibuprofen, zbyte\u010dn\u011b vystavuje pacienta gastrointestin\u00e1ln\u00edmu a ren\u00e1ln\u00edmu riziku.<\/p>\n

    Jak Ketorolac funguje?<\/h2>\n

    Ketorolac je neselektivn\u00ed NSAID<\/strong> \u2014 blokuje jak COX-1<\/strong> (kter\u00fd udr\u017euje \u017ealude\u010dn\u00ed sliznici, funkci krevn\u00edch desti\u010dek a prokrven\u00ed ledvin), tak COX-2<\/strong> (kter\u00fd je zv\u00fd\u0161en\u011b exprimov\u00e1n v m\u00edstech z\u00e1n\u011btu). Toto \u0161irok\u00e9 p\u016fsoben\u00ed vysv\u011btluje jak jeho siln\u00fd protiz\u00e1n\u011btliv\u00fd \u00fa\u010dinek, tak jeho dob\u0159e zn\u00e1m\u00fd profil gastrointestin\u00e1ln\u00edch a ren\u00e1ln\u00edch ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f.<\/p>\n

    Terapeutick\u00fd \u0159et\u011bzec ud\u00e1lost\u00ed je u v\u0161ech NSAID stejn\u00fd:<\/p>\n

      \n
    1. Po\u0161kozen\u00ed tk\u00e1n\u011b nebo z\u00e1n\u011bt uvol\u0148uje fosfolipidy z bun\u011b\u010dn\u00fdch membr\u00e1n<\/li>\n
    2. Fosfolip\u00e1za A\u2082 je p\u0159em\u011b\u0148uje na kyselinu arachidonovou<\/li>\n
    3. Cyklooxygen\u00e1za (COX-1\/COX-2) p\u0159em\u011b\u0148uje kyselinu arachidonovou na prostaglandiny<\/strong> \u2014 molekuly zodpov\u011bdn\u00e9 za bolest, otok a hore\u010dku<\/li>\n
    4. Ketorolac blokuje COX enzymy, \u010d\u00edm\u017e se sni\u017euje tvorba prostaglandin\u016f, co\u017e vede k men\u0161\u00ed bolesti a z\u00e1n\u011btu<\/li>\n<\/ol>\n

      Proto\u017ee prostaglandiny tak\u00e9 chr\u00e1n\u00ed \u017ealude\u010dn\u00ed sliznici, reguluj\u00ed pr\u016ftok krve ledvinami a ovliv\u0148uj\u00ed funkci krevn\u00edch desti\u010dek, stejn\u00fd mechanismus, kter\u00fd zm\u00edr\u0148uje bolest, je tak\u00e9 zodpov\u011bdn\u00fd za hlavn\u00ed vedlej\u0161\u00ed \u00fa\u010dinky NSAID: podr\u00e1\u017ed\u011bn\u00ed \u017ealudku, zadr\u017eov\u00e1n\u00ed tekutin, vysok\u00fd krevn\u00ed tlak a (u n\u011bkter\u00fdch jedinc\u016f) z\u00e1t\u011b\u017e ledvin.<\/p>\n

      D\u00e1vkov\u00e1n\u00ed Ketorol DT<\/h2>\n
        \n
      • Peror\u00e1ln\u011b:<\/strong> 10 mg ka\u017ed\u00fdch 4\u20136 hodin podle pot\u0159eby, maxim\u00e1ln\u011b 40 mg\/den<\/li>\n
      • Maxim\u00e1ln\u00ed celkov\u00e1 doba l\u00e9\u010dby (v\u0161echny cesty pod\u00e1n\u00ed dohromady):<\/strong> 5 dn\u00ed<\/li>\n
      • Star\u0161\u00ed pacienti (> 65 let), t\u011blesn\u00e1 hmotnost < 50 kg nebo m\u00edrn\u00e9 ren\u00e1ln\u00ed po\u0161kozen\u00ed:<\/strong> maxim\u00e1ln\u011b 40 mg\/den a celkov\u00e1 doba l\u00e9\u010dby ide\u00e1ln\u011b \u2264 2\u20133 dny<\/li>\n<\/ul>\n

        Nep\u0159ekra\u010dujte 5 dn\u016f souvisl\u00e9 terapie ketorolakem<\/strong> v jak\u00e9koli form\u011b. Riziko gastrointestin\u00e1ln\u00edho v\u0159edu a po\u0161kozen\u00ed ledvin po tomto obdob\u00ed prudce stoup\u00e1. Po 5. dni p\u0159ejd\u011bte na alternativn\u00ed analgetikum (ibuprofen, diklofenak nebo paracetamol).<\/p>\n

        Jak u\u017e\u00edvat:<\/strong> um\u00edst\u011bte DT tabletu na jazyk, nechte ji rozpadnout (5\u201315 sekund), spolkn\u011bte se slinami. Voda nen\u00ed pot\u0159eba. Pokud mo\u017eno u\u017e\u00edvejte s j\u00eddlem nebo ml\u00e9kem.<\/p>\n

        \n

        GI bezpecnost \u2014 precist pred prvnim uzitim.<\/strong> Ka\u017ed\u00e9 NSAID, v\u010detn\u011b Ketorol DT, nese skute\u010dn\u00e9 riziko gastritidy, peptick\u00e9ho v\u0159edu a krv\u00e1cen\u00ed v horn\u00ed \u010d\u00e1sti tr\u00e1vic\u00edho traktu. Riziko je nejvy\u0161\u0161\u00ed u pacient\u016f nad 65 let, u t\u011bch s p\u0159edchoz\u00edm v\u0159edov\u00fdm onemocn\u011bn\u00edm a u kohokoli, kdo z\u00e1rove\u0148 u\u017e\u00edv\u00e1 n\u00edzk\u00e9 d\u00e1vky aspirinu, kortikosteroidy, SSRI nebo antikoagulancia. U\u017e\u00edvejte Ketorol DT s j\u00eddlem<\/em>, pouzijte nejnizsi ucinnou davku po nejkratsi rozumne dlouhou dobu<\/em>, a zeptejte se lekare na predpis inhibitoru protonove pumpy (omeprazol, pantoprazol), pokud ho potrebujete dele nez 2\u20134 tydny.<\/p>\n<\/div>\n

        Specifick\u00e1 varov\u00e1n\u00ed pro ketorolak:<\/strong> Proto\u017ee je ketorolak na miligram neobvykle \u00fa\u010dinn\u00fd, m\u00e1 vy\u0161\u0161\u00ed v\u00fdskyt gastrointestin\u00e1ln\u00edch v\u0159ed\u016f, krv\u00e1cen\u00ed a akutn\u00edho po\u0161kozen\u00ed ledvin ne\u017e v\u011bt\u0161ina ostatn\u00edch peror\u00e1ln\u00edch NSAID p\u0159i srovnateln\u00fdch d\u00e1vk\u00e1ch pro \u00falevu od bolesti. Proto existuje 5denn\u00ed limit, kter\u00fd je nutn\u00e9 dodr\u017eet.<\/p>\n

        Kdo by nem\u011bl u\u017e\u00edvat Ketorol DT?<\/h2>\n
          \n
        • Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost na ketorolak nebo jak\u00e9koli NSAID<\/li>\n
        • Aktivn\u00ed nebo opakuj\u00edc\u00ed se peptick\u00fd v\u0159ed, krv\u00e1cen\u00ed nebo perforace tr\u00e1vic\u00edho traktu<\/li>\n
        • Astma, kop\u0159ivka nebo rinitida vyvolan\u00e1 aspirinem nebo jin\u00fdm NSAID (\u201caspirinem exacerbovan\u00e9 respira\u010dn\u00ed onemocn\u011bn\u00ed\u201d)<\/li>\n
        • T\u011b\u017ek\u00e9 srde\u010dn\u00ed selh\u00e1n\u00ed (NYHA t\u0159\u00edda IV)<\/li>\n
        • T\u011b\u017ek\u00e9 po\u0161kozen\u00ed jater (Child\u2013Pugh C)<\/li>\n
        • T\u011b\u017ek\u00e9 po\u0161kozen\u00ed ledvin (CrCl < 30 ml\/min)<\/li>\n
        • T\u0159et\u00ed trimestr t\u011bhotenstv\u00ed (riziko p\u0159ed\u010dasn\u00e9ho uzav\u0159en\u00ed ductus arteriosus a oligohydramnionu)<\/li>\n
        • Ned\u00e1vn\u00e1 operace koron\u00e1rn\u00edho bypassu (CABG) \u2014 absolutn\u00ed kontraindikace pro v\u0161echna NSAID<\/li>\n<\/ul>\n

          Specifick\u00e9 pro ketorolak:<\/strong><\/p>\n

            \n
          • Podez\u0159en\u00ed nebo skute\u010dn\u00e9 krv\u00e1cen\u00ed do mozku, hemoragick\u00e1 diat\u00e9za, ne\u00fapln\u00e1 hemost\u00e1za<\/li>\n
          • Aktu\u00e1ln\u00ed, ned\u00e1vn\u00fd nebo vysok\u00e9 riziko gastrointestin\u00e1ln\u00edho v\u0159edu nebo krv\u00e1cen\u00ed<\/li>\n
          • Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed jin\u00fdch NSAID nebo aspirinu<\/li>\n
          • Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed pentoxifylinu nebo probenecidu<\/li>\n
          • Hypovol\u00e9mie \u2013 nejprve korigovat<\/li>\n
          • Porod (inhibuje d\u011blo\u017en\u00ed kontrakce, m\u016f\u017ee odd\u00e1lit porod)<\/li>\n
          • Pou\u017eit\u00ed u d\u011bt\u00ed ve v\u011bt\u0161in\u011b jurisdikc\u00ed<\/li>\n<\/ul>\n

            Kardiovaskul\u00e1rn\u00ed riziko<\/h3>\n

            V\u0161echna NSAID (krom\u011b n\u00edzk\u00fdch d\u00e1vek aspirinu) nesou ur\u010dit\u00e9 zv\u00fd\u0161en\u00ed rizika infarktu a mrtvice a mohou zhor\u0161it srde\u010dn\u00ed selh\u00e1n\u00ed. Riziko je z\u00e1visl\u00e9 na d\u00e1vce a d\u00e9lce u\u017e\u00edv\u00e1n\u00ed a je obecn\u011b nejvy\u0161\u0161\u00ed u COX-2 selektivn\u00edch l\u00e1tek a u diklofenaku. Pacienti s prok\u00e1zan\u00fdm ischemick\u00fdm onemocn\u011bn\u00edm srdce, perifern\u00edm arteri\u00e1ln\u00edm onemocn\u011bn\u00edm, mrtvic\u00ed nebo nekontrolovanou hypertenz\u00ed by m\u011bli pou\u017e\u00edvat neselektivn\u00ed NSAID (ibuprofen nebo naproxen) v nejni\u017e\u0161\u00ed \u00fa\u010dinn\u00e9 d\u00e1vce, nebo pokud mo\u017eno m\u00edsto nich paracetamol.<\/p>\n

            Ren\u00e1ln\u00ed (ledvinov\u00e1) bezpe\u010dnost<\/h3>\n

            NSAID sni\u017euj\u00ed produkci ren\u00e1ln\u00edch prostaglandin\u016f, co\u017e m\u016f\u017ee zp\u016fsobit zadr\u017eov\u00e1n\u00ed sol\u00ed a vody, zv\u00fd\u0161en\u00ed krevn\u00edho tlaku a \u2013 u zraniteln\u00fdch pacient\u016f \u2013 akutn\u00ed po\u0161kozen\u00ed ledvin. Mezi vysoce rizikov\u00e9 skupiny pat\u0159\u00ed star\u0161\u00ed pacienti, pacienti u\u017e\u00edvaj\u00edc\u00ed ACE inhibitory\/ARB spolu s diuretiky (tzv. \u201ctrojit\u00fd z\u00e1sah\u201d), dehydratovan\u00ed jedinci (zvracen\u00ed, pr\u016fjem, horko, intenzivn\u00ed cvi\u010den\u00ed) a pacienti s ji\u017e existuj\u00edc\u00edm CKD. P\u0159esta\u0148te u\u017e\u00edvat NSAID a vyhledejte l\u00e9ka\u0159skou kontrolu, pokud se u v\u00e1s objev\u00ed sn\u00ed\u017een\u00fd v\u00fddej mo\u010di, otoky nebo nevysv\u011btlen\u00fd p\u0159\u00edr\u016fstek hmotnosti.<\/p>\n

            Vedlej\u0161\u00ed \u00fa\u010dinky p\u0159\u00edpravku Ketorol DT<\/h2>\n