Usage
- Gatifloxacin + Ketorolac ophthalmic solution is prescribed for the treatment and prevention of post-operative ocular inflammation and pain, and bacterial conjunctivitis (pink eye). It is also effective in managing ocular burning, irritation, and itching associated with eye surgeries.
- Pharmacological Classification:
- Gatifloxacin: Fluoroquinolone antibiotic
- Ketorolac: Non-steroidal anti-inflammatory drug (NSAID)
- Mechanism of Action:
- Gatifloxacin inhibits bacterial DNA gyrase and topoisomerase IV, enzymes essential for bacterial DNA replication and repair, thereby killing bacteria.
- Ketorolac inhibits cyclooxygenase (COX) enzymes, reducing the production of prostaglandins, which mediate inflammation and pain.
Alternate Names
- This combination medication may be referred to as Gatifloxacin/Ketorolac ophthalmic solution.
- Brand Names: Ketogate, Gatilox Plus, Gcom, Ketomar
How It Works
- Pharmacodynamics:
- Gatifloxacin exerts its bactericidal effect by disrupting bacterial DNA synthesis.
- Ketorolac provides analgesic and anti-inflammatory effects by inhibiting prostaglandin synthesis.
- Pharmacokinetics:
- Both drugs are administered topically to the eye. Systemic absorption is minimal.
- Metabolism and elimination pathways for the ophthalmic solution are not well-defined as systemic exposure is low.
- Mode of Action:
- Gatifloxacin targets bacterial DNA gyrase and topoisomerase IV.
- Ketorolac targets COX-1 and COX-2 enzymes.
- Elimination Pathways: Primarily local elimination, with limited systemic involvement.
Dosage
Standard Dosage
Adults:
- Instill one drop into the affected eye(s) four times daily.
- Treatment duration is typically determined by the physician based on the patient’s condition.
Children:
- One drop four times a day as directed by the physician
- No information available for the use in Children below 2 years
- Use with caution under medical supervision
Special Cases:
- Elderly Patients: Use with caution due to potential age-related decline in renal function.
- Patients with Renal Impairment: Use with caution. Dose adjustment may be necessary in moderate renal impairment. Severe renal impairment is a contraindication.
- Patients with Hepatic Dysfunction: Use with caution.
- Patients with Comorbid Conditions: Caution is advised in patients with asthma, bleeding disorders, or allergies to either component.
Clinical Use Cases
- Primarily used for post-operative ocular inflammation and pain. Dosage as per standard adult recommendations.
Dosage Adjustments:
- Dose adjustments are based on renal function and age.
Side Effects
Common Side Effects:
- Eye irritation, burning or stinging
- Watery eyes
- Blurred vision
- Headache
- Changes in taste
Rare but Serious Side Effects:
- Severe eye pain
- Vision changes
Long-Term Effects:
- Not typically associated with long-term systemic effects due to minimal systemic absorption when used ophthalmically.
Contraindications
- Hypersensitivity to gatifloxacin, ketorolac, other quinolones, or NSAIDs.
- History of corneal ulcers.
- Severe renal impairment.
Drug Interactions
- Blood thinners (e.g., warfarin)
- Corticosteroids (e.g., prednisolone)
- Other ocular antibiotics (e.g., moxifloxacin)
- Alcohol (increased risk of gastrointestinal bleeding)
Pregnancy and Breastfeeding
- Safety not established. Use only if absolutely necessary and after consultation with a physician.
Drug Profile Summary
- Mechanism of Action: Gatifloxacin: Inhibits bacterial DNA gyrase and topoisomerase IV. Ketorolac: Inhibits COX enzymes, reducing prostaglandin synthesis.
- Side Effects: Eye irritation, burning, blurred vision, headache.
- Contraindications: Hypersensitivity, corneal ulcers, severe renal impairment.
- Drug Interactions: Blood thinners, corticosteroids, other ocular antibiotics, alcohol.
- Pregnancy & Breastfeeding: Not recommended unless essential.
- Dosage: 1 drop four times daily.
- Monitoring Parameters: Monitor for signs of eye infection, allergic reactions, and vision changes.
Popular Combinations:
- Often used alone. Combinations with other ophthalmic medications are generally avoided unless specifically directed by a physician.
Precautions
- Avoid touching the dropper tip to any surface to prevent contamination.
- Remove contact lenses before use and wait 15 minutes before reinserting.
- Caution in patients with diabetes, arthritis, or bleeding problems.
- May temporarily impair vision; avoid driving or operating machinery until vision clears.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Gatifloxacin + Ketorolac?
A: The standard dosage is one drop in the affected eye(s) four times a day.
Q2: How long should I use Gatifloxacin + Ketorolac?
A: Use as directed by your physician. The duration of treatment depends on the condition being treated.
A: Remove contact lenses before instilling the drops and wait at least 15 minutes before reinserting.
Q4: What are the common side effects?
A: Common side effects include eye irritation, burning, watery eyes, blurred vision, and headache.
Q5: Can pregnant or breastfeeding women use this medication?
A: Use only if absolutely necessary and after consultation with a physician. The safety during pregnancy and breastfeeding is not well established.
Q6: What should I do if I miss a dose?
A: Instill the missed dose as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue your regular schedule.
Q7: Are there any serious side effects I should be aware of?
A: Although rare, severe eye pain or vision changes warrant immediate medical attention.
Q8: Can I drink alcohol while using Gatifloxacin + Ketorolac?
A: Alcohol is not recommended as it may increase the risk of gastrointestinal bleeding, especially when Ketorolac is administered systemically. With topical application, the systemic absorption is very low so the risk is also minimal.
Q9: What precautions should I take while using this medication?
A: Avoid touching the dropper tip to any surface. Remove contact lenses before use. Be cautious when driving or operating machinery, as blurred vision may occur.
