Dosing and uses of Acular, Acular LS (ketorolac ophthalmic)
Adult dosage forms and strengths
ophthalmic solution
- 0.4% (Acular LS)
- 0.45% (Acuvail)
- 0.5% (Acular)
Allergic Conjunctivitis
Indicated for temporary relief of ocular itching caused by seasonal allergic conjunctivitis
Acular: Instill 1 gtt in affected eye(s) q6hr
Ocular Pain & Inflammation
Indicated for pain and inflammation following catarac surgery
Acuvail: Instill 1 gtt to affected eye(s) twice daily beginning 1 day before surgery and on day of surgery and continue through the first 2 weeks postoperatively
Acular: Instill 1 gtt in affected eye(s) four times daily starting 24 hr after surgery and continue up to 4 days after surgery
Ocular Pain & Burning/Stinging
Indicated to reduce ocular pain and burning/stinging following corneal refractive surgery
Acular LS: Instill 1 gtt in the operated eye PRN for up to 4 days postoperatively
Cystoid Macular Edema (Off-label)
Prevention of postoperatvie cystoid macular edema
1-2 gtt in affected eye(s) q6-8hr beginning 24 hr pre-op and continuing 3-4 wk postoperatively
Pediatric dosage forms and strengths
ophthalmic solution
- 0.4% (Acular LS)
- 0.45% (Acuvail)
- 0.5% (Acular)
Allergic Conjunctivitis
Indicated for temporary relief of ocular itching caused by seasonal allergic conjunctivitis
<2 years: Safety and efficacy not established
>2 years: Instill 1 gtt in affected eye(s) q6hr (Acular)
Ocular Pain & Inflammation
Indicated for pain and inflammation following catarac surgery
<2 years: Safety and efficacy not established
>2 years: Instill 1 gtt (Acular) in affected eye(s) q6hr starting 24 hr after surgery and continue through the first 2 weeks postoperatively
Ocular Pain & Burning/Stinging
Indicated to reduce ocular pain and burning/stinging following corneal refractive surgery
<2 years: Safety and efficacy not established
>2 years: Instill 1 gtt (Acular LS) in operated eye PRN for up to 4 days postoperatively
Acular, Acular LS (ketorolac ophthalmic) adverse (side) effects
>10%
Transient ocular burning/stinging
1-10%
Conjunctival hyperemia
Corneal edema
Iritis
Corneal infiltrates
Iritis
Corneal edema
Ocular inflammation
Ocular irritation
Ocular pain
Increased ocular pressure
Superficial keratitis
Superficial ocular infection
<1%
Blurred vision
Corneal ulcer
Corneal erosion
Corneal thinning
Perforation of cornea
Dry eyes
Epithelial breakdown
Corneal epithelial degeneration
Postmarketing reports
Bronchospasm, exacerbation of asthma, and epithelial breakdown
Warnings
Contraindications
Hypersensitivity to ASA or NSAIDs
Cautions
Ocular infection possible following surgery; patients should use two bottles should not use the same bottle for both eyes
Safety and efficacy of Acular LS not established in postcataract surgery patients
NSAIDs may delay healing
Cross-sensitivity or hypersensitivity may occur between other NSAIDs, acetylsalicylic acid, and phenylacetic acid derivatives
Increased bleeding time due to interference with thrombocyte aggregation; reports that ocularly applied NSAIDs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery
May cause keratitis, and in some susceptible patients, chronic use may cause epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration, or corneal perforation
Do not administer while wearing contact lenses
Pregnancy and lactation
Pregnancy category: C
Lactation: Unknown; use with caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Acular, Acular LS (ketorolac ophthalmic)
Mechanism of action
Nonsteroidal anti-inflammatory agent; reduces production of prostaglandin precursors by inhibiting COX-1 and COX-2; has anti-inflammatory properties
