Product Information

Registration Status: Active

ACUVAIL (KETOROLAC TROMETHAMINE OPHTHALMIC SOLUTION) 0.45% is approved to be sold in Singapore with effective from 2012-10-29. It is marketed by ALLERGAN SINGAPORE PTE LTD, with the registration number of SIN14259P.

This product contains Ketorolac 0.45% W/V in the form of SOLUTION, STERILE. It is approved for OPHTHALMIC use.

This product is manufactured by Allergan Sales in UNITED STATES.

It is a Prescription Only Medicine that can only be obtained from a doctor or a dentist, or a pharmacist with a prescription from a Singapore-registered doctor or dentist.



A pyrrolizine carboxylic acid derivative structurally related to indomethacin. It is an NSAID and is used principally for its analgesic activity. (From Martindale The Extra Pharmacopoeia, 31st ed)


For the short-term (~5 days) management of moderately severe acute pain that requires analgesia at the opioid level, usually in a postoperative setting.

Mechanism of Action

Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) chemically related to indomethacin and tolmetin. Ketorolac tromethamine is a racemic mixture of [-]S- and [+]R-enantiomeric forms, with the S-form having analgesic activity. Its antiinflammatory effects are believed to be due to inhibition of both cylooxygenase-1 (COX-1) and cylooxygenase-2 (COX-2) which leads to the inhibition of prostaglandin synthesis leading to decreased formation of precursors of prostaglandins and thromboxanes from arachidonic acid. The resultant reduction in prostaglandin synthesis and activity may be at least partially responsible for many of the adverse, as well as the therapeutic, effects of these medications. Analgesia is probably produced via a peripheral action in which blockade of pain impulse generation results from decreased prostaglandin activity. However, inhibition of the synthesis or actions of other substances that sensitize pain receptors to mechanical or chemical stimulation may also contribute to the analgesic effect. In terms of the ophthalmic applications of ketorolac - ocular administration of ketorolac reduces prostaglandin E2 levels in aqueous humor, secondary to inhibition of prostaglandin biosynthesis.


Rapidly and completely absorbed after oral administration
* 0.26 ± 0.08 L/kg [children 4 to 8 years old]
Primarily hepatic. Less than 50% of a dose is metabolized. The major metabolites are a glucuronide conjugate, which may also be formed in the kidney, and p-hydroxy ketorolac. Neither metabolite has significant analgesic activity.


* 0.042 +/- 0.01 L/hr/kg [Pediatric Patients] * 0.02 L/h/kg [Normal Subjects IM] * 0.03 L/h/kg [Normal Subjects oral] * 0.02 L/h/kg [Healthy Elderly Subjects IM] * 0.02 L/h/kg [Healthy Elderly Subjects oral] * 0.03 L/h/kg [Patients with Hepatic Dysfunction IM] * 0.03 L/h/kg [Patients with Hepatic Dysfunction oral] * 0.02 L/h/kg [Patients with Renal Impairment IM] * 0.02 L/h/kg [Patients with Renal Impairment oral] * 0.02 L/h/kg [Renal Dialysis Patients IM]


LD50 = 189 mg/kg (rat, oral).

Active Ingredient/Synonyms

(+-)-5-Benzoyl-2,3-dihydro-1H-pyrrolizine-1-carboxylic acid | (+-)-Ketorolac | Ketorolac | Kétorolac | Ketorolaco | Ketorolacum | rac-Ketorolac | Ketorolac |

Source of information: Drugbank (External Link). Last updated on: 3rd July 18. *Trade Name used in the content below may not be the same as the HSA-registered product.


  1. Health Science Authority of Singapore - Reclassified POM
  2. Drugbank