Ketorolac+tramadol

Ketorolac+tramadol should not be used in case of any known allergy to either of the components or to NSAID’s/opioids in general. Ketorolac+tramadol is not recommended for use in case of high risk or previous history of peptic ulcer disease, bleeding disorders, heart failure, asthma, IBD or if you have had any kind of stroke (even transient ischaemic stroke). Ketorolac+tramadol should be used with caution in patients with a known history of substance abuse (individual or within the family), diabetes mellitus, epilepsy, kidney disease, liver disease, arterial or thrombotic disorders, cardiovascular health disorders, mental health issues, asthma, emphysema, pancreatitis, gallbladder disease, bleeding disorders, peptic ulcers, IBD/IBS, enlarged prostate, rheumatoid arthritis, dry eye syndrome, hypertension, obesity, anaemia, nasal polyps (overgrowth in the nose), stroke and any disease-causing swelling in the feet and hands. Consult your doctor before using Ketorolac+tramadol during pregnancy or breastfeeding as it is not recommended for use in these states. 

Drug-Drug Interactions: Ketorolac+tramadol may interact with other pain-killers (pentazocin, pentoxifylline, nalbuphine, butorphanol, anti-addiction drug (naltrexone), antihypertensives (captopril, lisinopril, losartan), diuretics (furosemide), mood stabiliser (lithium), DMARD (methotrexate), steroids (prednisolone), blood-thinners (clopidogrel, warfarin, enoxaparin), anti-gout drug (probenecid), anti-epileptic drugs (phenytoin, carbamazepine), psychoactive drugs (fluoxetine, alprazolam), anti-depressants (SSRI’s like citalopram, escitalopram), MAOI’s (selegiline, phenelzine, linezolid, methylene blue, moclobemide, procarbazine), heart medication (quinidine), anti-HIV drug (ritonavir), antifungals (itraconazole, ketoconazole), antibiotics (erythromycin).

Drug-Food Interactions: Ketorolac+tramadol may interact with high-fat foods and alcohol.

Drug-Disease Interactions: Ketorolac+tramadol should be used with caution in patients with a known history of substance abuse (individual or within the family), hypersensitivity disorder, diabetes mellitus, epilepsy, kidney disease, liver disease, arterial or thrombotic disorders, cardiovascular health disorders, mental health issues, asthma, emphysema, pancreatitis, gallbladder disease, bleeding disorders, peptic ulcers, IBD/IBS, enlarged prostate, rheumatoid arthritis, dry eye syndrome, hypertension, obesity, anaemia, nasal polyps (overgrowth in the nose), stroke and any disease causing a swelling in the feet and hands.

• Stay hydrated by drinking plenty of water.
• Invest in a balanced diet. Load up on lean meats, fruits, green leafy vegetables, nuts, oily fish etc. Limit your intake of sweets and sugars as these can worsen inflammation. 
• Cut back on alcohol as this can have an adverse effect on pain states as well as the quality of your sleep.
• Try meditation and deep breathing to reduce overall stress and pain. 
• Stop smoking as smoking is known to worsen pain conditions. 
• Engage in mild physical exercise daily and keep your body active. 

• In case you miss a dose of Ketorolac+tramadol, skip it and resume when it is time for the second dose only. Do not ever take a double dose.
• It is very difficult to overdose on Ketorolac+tramadol however, if you accidentally take extra doses of Ketorolac+tramadol, please inform your doctor or go to a hospital immediately. Some of the symptoms of an overdose can be blurred vision, shortness of breath, difficulty in speaking, severe headache, unusual tiredness, fainting and or ringing in the ears. 
• Avoid taking antacids within 2-3 hours of Ketorolac+tramadol.