Sprix

1 What is Sprix?

Sprix (Ketorolac) is a  nasal spray is used to treat moderate to severe pain. Ketorolac is a non-steroidal anti-inflammatory drug (NSAID), and it works by reducing substances in the blood that cause pain and inflammation. Doctors prescribe Sprix to treat moderate to the severe pan, and it is as effective as opioids in delivering pain relief.

Sprix should be used only for short-term. It must be used no longer than 5 days  at the maximum.

Sprix requires a prescription.

Sprix may increase the risk of serious bleeding in the stomach and intestines, which can cause death. Stomach and intestinal bleeding can occur anytime and without warning. Sprix may also increase the risk of heart attack and stroke, which may occur early in treatment and may increase as the drug is used for longer periods of time. Only use Sprix according to doctor’s instructions.

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2 What to know before using

Before prescribing Sprix, the doctor will have to consider the following first.

Allergies

You cannot use Sprix if you have allergies to Ketorolac. If you experienced allergies to Ketorolac before, tell it to your doctor. Also tell the doctor all the allergies you have. Sprix is highly contraindicated in patients that experienced hives, itching or asthma after taking Aspirin and other NSAIDs.

Use of Sprix as painkiller

Do not use Sprix as a painkiller for any major surgery. Sprix must be used only with doctor’s supervision.

Use on children

Do not give Ketorolac nasal spray for patients aged 18 years old and below.

Pregnancy and breastfeeding

Tell the doctor if you are pregnant or breastfeeding before using Ketorolac nasal spray. Ketorolac is an FDA pregnancy category C drug, which means it may cause harm to the unborn baby when given to pregnant patients. Do not breastfeed when taking Ketorolac nasal spray because the drug can be expressed through breast milk.

Alcohol use

You cannot take alcohol while using Sprix. Alcohol can increase risks of side effects of Ketorolac. Tell the doctor if you regularly take alcohol or have a history of alcohol abuse.

Use of Sprix as painkiller

Do not use Sprix as a painkiller for any major surgery. Sprix must be used only with doctor’s supervision.

Health conditions

Tell all your health problems to the doctor before using Sprix. You cannot use Sprix if you just have had coronary artery bypass graft (CABG) surgery or other procedures in the heart.

Do not use Sprix if you have the following health problems:

  • Have suspected or active stomach or intestinal ulcers, bleeding or perforation anywhere in the digestive tract
  • Have serious kidney problems or are at risk of kidney disease due to dehydration or hypovolemia.
  • Under labor or will deliver a baby shortly
  • Have suspected or confirmed stroke or bleeding inside the head
  • Highly susceptible to bleeding

The doctor will need to know if you have the following health problems before prescribing Sprix:

Drug interactions

Tell the doctor all the drugs you take before receiving Ketorolac nasal spray. You cannot use Sprix if you also take Pentoxifylline or Probenecid. Do not take Sprix if you are also taking other NSAIDs for pain, such as Aspirin and Ibuprofen.

Tell the doctor if you are taking the following medicines before using Sprix:

  • Warfarin and other drugs that inhibit blood clotting
  • Aspirin, Ibuprofen, Acetaminophen, Naproxen sodium and other NSAIDs
  • Drugs for the heart such as ACE inhibitors, angiotensin receptor blockers, beta blockers
  • Water pills such as Furosemide and Hydrochlorothiazide
  • Digoxin
  • Lithium
  • Methotrexate
  • Cyclosporine
  • Pemetrexed
  • Probenecid
  • Drugs for seizures and for epilepsy
  • Drugs for mental disorders, depression and mood disorders
  • Muscle relaxants

3 Proper usage

Sprix contains an additional information guide. Be sure to completely understand the information on this guide before using Sprix.

Sprix is packaged in single-day spray bottles, each bottle is only good for a day. Each Sprix bottle has enough solution for eight sprays, each spray designed to deliver a precisely metered dose of 100 micrograms of Ketorolac.

Sprix must be used according to doctor’s prescription. The doctor usually starts at the lowest dose. Sprix is usually taken every 6 to 8 hours.

Observe the following instructions in using Sprix. Note that you must not inhale the spray. If you need help in using Sprix, ask your doctor or health provider:

  • First, blow and gently clear your nose.
  • If using a new spray bottle, remove the clip and then prime the unit by pumping 5 sprays in the air until a fine mist appears. Do not inhale this mist.
  • To start administration, tilt the head slightly forward.
  • Insert tip of the bottle in the nostril, making sure to point it away from the center of the nose so the spray will be absorbed on the nasal passages.
  • Breathe through the mouth, and then spray the medication gently
  • Do not inhale or sniff while spraying. If your nose starts to run, gently sniff to prevent medication from leaking
  • Replace the cap and store the medication

Once opened, each bottle of Sprix is only good for one day. After 24 hours, the whole bottle must be disposed of even if there is still some medicine inside it.

When spraying Sprix, take care not to spray the medication in your eyes. If this happens, rinse the eyes with clean water or saline solution. If eye irritation occurs and persists for more than an hour, call the doctor.

If you missed a dose of Sprix, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and return to the original dosing schedule. Do not take more of the medicine to make up for the missed dose.

Taking more Sprix can cause an overdose. If you took too much of the medicine, call the doctor or local poison control hotline right away.

Store unopened Sprix in the refrigerator. Opened Ketorolac nasal spray bottles can be stored at room temperature. Keep Sprix away from heat, light and moisture.

4 Precautions to take

In using Ketorolac nasal spray, do not take more sprays than what the doctor prescribed. An overdose can cause serious side effects.

Do not use Ketorolac nasal spray for more than 5 days unless instructed by the doctor.

Do not use over-the-counter medications while using Ketorolac nasal spray unless prescribed by the doctor. Medicines for fever, colds and flu may contain NSAIDs that can interact with Ketorolac nasal spray.

The doctor may order frequent lab tests while you use Ketorolac nasal spray to monitor your condition and detect early signs of side effects. Always stick to clinic and lab appointments while receiving Ketorolac nasal spray.

Do not take alcohol while receiving Ketorolac nasal spray.

Dispose Ketorolac nasal spray carefully and keep it away from others.

If you became pregnant or breastfeed while taking Ketorolac nasal spray, call the doctor right away.

5 Potential side effects

Sprix may cause side effects that require immediate medical attention. Call your doctor right away if you experience the following side effects while taking Sprix:

  • Severe allergic reaction symptoms such as skin itching, hives, difficulty breathing, swelling of the nose, throat, tongue and lips.
  • Heart attack symptoms such as dull chest pain or pressure that spread to the jaw, shoulder or the back, nausea, sweating and severe anxiety.
  • Stroke symptoms such as sudden numbness or weakness especially on one side of the body, sudden severe headache, slurred speech, vision and speech disturbances.
  • Stomach bleeding symptoms such as coughing up vomit that looks like coffee grounds, gross blood in vomit, passing out bloody or tarry stools.
  • Liver problem symptoms such as nausea, stomach pain, itching, severe fatigue, loss of appetite, flu-like symptoms, passing out clay colored stools and jaundice
  • Kidney problems such as passing too little or no urine, painful or difficult urination, swelling of the feet or ankles, tiredness or shortness of breath.
  • Anemia symptoms such as paleness, lightheadedness or fainting, shortness of breath, rapid heartbeats, and trouble concentrating.
  • Severe skin reaction symptoms such as fever,sore throat, burning pain in the eyes, redness, swelling, blistering of skin, and appearance of red or purple skin rash.
  • Shortness of breath, even with mild exertion
  • Any swelling or rapid weight gain
  • Skin rash, even if it is mild

Sprix may cause minor side effects such as:

  • Pain or irritation in the nose
  • Runny or watery nose
  • Watery eyes
  • Irritation in the throat
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