Comparative Pharmacology
Head-to-head clinical analysis: KETOROLAC TROMETHAMINE AND PHENYLEPHRINE HYDROCHLORIDE versus VIVLODEX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: KETOROLAC TROMETHAMINE AND PHENYLEPHRINE HYDROCHLORIDE versus VIVLODEX.
KETOROLAC TROMETHAMINE AND PHENYLEPHRINE HYDROCHLORIDE vs VIVLODEX
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2), reducing prostaglandin synthesis. Phenylephrine is a selective alpha-1 adrenergic receptor agonist, causing vasoconstriction.
COX-2 inhibitor; reduces prostaglandin synthesis via inhibition of cyclooxygenase-2 (COX-2) with minimal COX-1 inhibition.
Ophthalmic: 1 drop of the combination (ketorolac tromethamine 0.45% and phenylephrine hydrochloride 1%) into the operative eye three times daily, beginning 1 day prior to surgery and continuing on the day of surgery and for 2 weeks postoperatively.
Once daily oral administration of 100 mg or 200 mg capsules. The recommended dose is 100 mg once daily; dose may be increased to 200 mg once daily if response is inadequate. Maximum daily dose: 200 mg.
None Documented
None Documented
Ketorolac: 2.4-8.6 hours (mean 5.3 hours) in young adults; prolonged in elderly (up to 13.9 hours) and renal impairment. Phenylephrine: 2-3 hours.
Terminal elimination half-life of the active moiety meloxicam is approximately 20 hours (range 12-24 h), allowing once-daily dosing in chronic pain.
Ketorolac: ~92% renal (60% as unchanged drug, 32% as metabolites), 6% fecal. Phenylephrine: primarily renal as metabolites (sulfate conjugates) with <1% unchanged.
VIVLODEX is a meloxicam NSAID prodrug. Following hydrolysis to meloxicam, excretion is primarily hepatic (metabolism) and renal (urine). Approximately 50% of meloxicam dose is excreted in urine as metabolites and <5% as parent drug; about 40% in feces. Biliary excretion is minor.
Category D/X
Category C
NSAID
NSAID