Side Effects of Acular (ketorolac)

Acular (ketorolac) is a nonsteroidal anti-inflammatory drug (NSAID) eyedrop used to treat allergic conjunctivitis (pink eye), post-operative inflammation pain, burning, and stinging after eye surgery such as cataract surgery or corneal refractive surgery. 

Acular blocks prostaglandin synthesis. Prostaglandins have many effects in the body including their role in pain and inflammation. 

In the eye prostaglandin is involved in inflammation, pain, and irritation due to allergies or mechanical injury. Acular provides relief from pain and inflammation in the eyes. 

Common side effects of Acular include

• burning and stinging of eyes,
• corneal edema,
• inflammation and irritation,
• eye infection,
• eye dryness,
• visual disturbances, and
• headache.

Serious side effects of Acular include severe

• burning, stinging, or itching eyes;
• a wound that will not heal;
• eye pain, redness, or watering;
• vision changes, increased sensitivity to light;
• white patches on the eyes; and
• crusting or drainage from the eyes.

Drug interactions of Acular include other NSAID eye drops due to risks of increased bleeding and delayed healing. 

• Acular should be used with caution with steroid-containing eye drops due to increased likelihood of infections. 
• Acular should be used with caution in patients who bleed easily or patients receiving blood thinners. 

There are no adequate studies done on Acular to determine safe and effective use in pregnant women. 

It is unknown if Acular enters breast milk; it is best to be cautious before using it in breastfeeding mothers.

Side effects of Ketorolac are:

• burning and stinging of eyes,
• corneal edema,
• inflammation and irritation,
• eye infection,
• dryness,
• visual disturbances, and
• headache.

Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to the rates in the clinical studies of another drug and may not reflect the rates observed in practice.

Clinical Studies Experience

The most frequent adverse reactions reported with the use of ketorolac tromethamine ophthalmic solutions have been transient stinging and burning on instillation. These reactions were reported by up to 40% of patients participating in clinical trials.

Other adverse reactions occurring approximately 1 to 10% of the time during treatment with ketorolac tromethamine ophthalmic solutions included

• allergic reactions,
• corneal edema,
• iritis,
• ocular inflammation,
• ocular irritation,
• superficial keratitis, and
• superficial ocular infections.

Other adverse reactions reported rarely with the use of ketorolac tromethamine ophthalmic solutions included:

• corneal infiltrates,
• corneal ulcer,
• eye dryness,
• headaches, and
• visual disturbance (blurry vision).

Postmarketing Experience

The following adverse reactions have been identified during post-marketing use of ketorolac tromethamine ophthalmic solution 0.5% in clinical practice. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made.

The reactions, which have been chosen for inclusion due to either their seriousness, frequency of reporting, possible causal connection to topical ketorolac tromethamine ophthalmic solution 0.5% or a combination of these factors, include

• bronchospasm or exacerbation of asthma,
• corneal erosion,
• corneal perforation,
• corneal thinning, and
• epithelial breakdown.

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