Ketotram 10mg/25mg Tablet: Comprehensive Medicine Guide
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Blood in stool or vomit
- Severe abdominal pain
- Chest pain or difficulty breathing
- Severe headache with visual changes
- Sudden swelling of face, lips, or throat
- Yellowing of skin or eyes
- Decreased urine output
- Unusual bruising or bleeding
- Extreme drowsiness or confusion
- Seizures
If experiencing severe symptoms, call emergency services immediately.
What is ketotru tablet used for?
This medicine is a prescription combination of ketorolac (an NSAID) and tramadol (an opioid analgesic) used for short-term relief of moderate to severe acute pain. It works by reducing inflammation and altering pain perception in the brain. It is not for long-term use and carries risks of bleeding, kidney problems, and dependence.
- Generic Name: Ketorolac (10mg) + Tramadol (25mg)
- Manufacturer: Wilshire Pharmaceuticals Pvt Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 ketotru tablet के बारे में (Hindi Summary)
उपयोग: यह दवा कीटोरोलैक (10 मिलीग्राम) और ट्रामाडोल (25 मिलीग्राम) का संयोजन है, जिसका उपयोग मध्यम से गंभीर तीव्र दर्द के अल्पकालिक उपचार के लिए किया जाता है, जैसे सर्जरी के बाद का दर्द, दांत का दर्द, या मांसपेशियों की चोट। यह दर्द और सूजन को कम करने के लिए काम करती है। यह केवल डॉक्टर के पर्चे पर मिलती है और इसे 5 दिनों से अधिक नहीं लेना चाहिए।
साइड इफेक्ट्स: आम दुष्प्रभावों में मतली, उल्टी, चक्कर आना, नींद आना, सिरदर्द, पेट दर्द, कब्ज और मुंह सूखना शामिल हैं। गंभीर दुष्प्रभावों में पेट या आंतों में रक्तस्राव, गुर्दे की समस्या, सांस लेने में कठिनाई, दौरे और गंभीर एलर्जी प्रतिक्रिया शामिल हो सकती है। यदि आपको काला मल, खून की उल्टी, गंभीर पेट दर्द, या सांस लेने में तकलीफ हो, तो तुरंत डॉक्टर से संपर्क करें।
सुरक्षा सलाह: इस दवा को डॉक्टर के निर्देशानुसार ही लें। निर्धारित मात्रा से अधिक न लें। शराब और अन्य नींद लाने वाली दवाओं से बचें। जब तक आपको पता न चले कि यह दवा आप पर कैसे असर करती है, तब तक वाहन न चलाएं। यदि आपको अल्सर, गुर्दे या लीवर की बीमारी, या रक्तस्राव विकार है, तो अपने डॉक्टर को बताएं। इसे बच्चों की पहुंच से दूर रखें।
💊 ketotru tablet Uses & Benefits
[{"condition":"Acute moderate to severe pain","description":"Short-term management of acute pain, such as postoperative pain, dental pain, or musculoskeletal injury pain, when opioid and NSAID combination is warranted.","evidence":"Well-established for short-term use"},{"condition":"Postoperative pain","description":"Used for the relief of pain following surgical procedures, often as part of multimodal analgesia.","evidence":"Well-established for short-term use"},{"condition":"Dental pain","description":"Relief of moderate to severe dental pain, including post-extraction pain.","evidence":"Well-established for short-term use"}]
Off-label uses: [{"condition":"Chronic pain","description":"Sometimes used off-label for chronic pain conditions, but not recommended due to risks of long-term NSAID and opioid use.","evidence":"Limited; not recommended for routine use"}]
Primary treatment for: Acute moderate to severe pain
Also treats: Postoperative pain, Dental pain, Musculoskeletal pain
📋 Drug Information
| Generic Name(s) | Ketorolac (10mg) + Tramadol (25mg) |
| Brand Name | ketotru tablet |
| Manufacturer | Wilshire Pharmaceuticals Pvt Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | PAIN ANALGESICS |
| Action Class | |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C (59°F to 86°F). Protect from light and moisture. Keep in the original container. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two analgesics with complementary mechanisms. Ketorolac inhibits cyclooxygenase enzymes (COX-1 and COX-2), reducing prostaglandin synthesis and thereby decreasing inflammation and pain. Tramadol acts centrally as a weak mu-opioid receptor agonist and also inhibits the reuptake of norepinephrine and serotonin, which enhances descending inhibitory pain pathways. Together, they provide synergistic analgesia.
Mechanism Steps
💡 How to Take ketotru tablet
Strength: Tablet containing ketorolac 10 mg and tramadol 25 mg.
Dosage Information
| Adult Dosage | The usual adult dose is one tablet (ketorolac 10 mg + tramadol 25 mg) taken orally every 6 to 8 hours as needed for pain, not to exceed 5 days of therapy. The maximum daily dose is 4 tablets (ketorolac 40 mg + tramadol 100 mg). Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function, and pain severity. Do not exceed the recommended dose or duration. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | Elderly patients (above 65 years) are at increased risk of gastrointestinal bleeding, kidney impairment, and central nervous system effects. Use with caution, and the dose may need to be reduced. Consult a doctor for individualized dosing. |
| Renal Impairment | In patients with moderate to severe kidney impairment (creatinine clearance <30 mL/min), this medicine is contraindicated. For mild impairment, dose adjustment may be necessary. Consult a doctor. |
| Hepatic Impairment | In patients with severe liver impairment, this medicine is contraindicated. For mild to moderate impairment, dose reduction may be needed. Consult a doctor. |
| Maximum Daily Dose | Maximum daily dose is 4 tablets (ketorolac 40 mg + tramadol 100 mg). Do not exceed this dose. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of ketotru tablet
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Warfarin | Major | |
| MAOIs | Major | |
| Benzodiazepines | Major | |
| SSRIs | Major | |
| Other NSAIDs | Major | |
| Diuretics | Moderate | |
| ACE inhibitors | Moderate | |
| CYP2D6 inhibitors | Moderate | |
| CYP3A4 inducers | Moderate | |
| Antacids | Minor |
🚨 Major Interactions
- Warfarin
- Monoamine oxidase inhibitors (MAOIs)
- Other CNS depressants (e.g., benzodiazepines, alcohol)
- Other NSAIDs
- SSRIs/SNRIs
⚡ Moderate Interactions
- Diuretics
- ACE inhibitors/ARBs
- CYP2D6 inhibitors (e.g., fluoxetine, quinidine)
- CYP3A4 inducers (e.g., rifampin, carbamazepine)
🍷 Alcohol Interaction
Avoid alcohol while taking this medicine. Alcohol increases the risk of gastrointestinal bleeding from ketorolac and enhances the sedative and respiratory depressant effects of tramadol, which can be dangerous.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Active peptic ulcer disease or history of gastrointestinal bleeding","Severe kidney impairment (e.g., creatinine clearance
⚠️ Warnings & Precautions
["This medicine is for short-term use only; do not exceed 5 days of therapy.","May cause drowsiness and dizziness; avoid driving or operating machinery.","Do not consume alcohol while taking this medicine.","May increase risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke.","May cause gastrointestinal bleeding, ulceration, and perforation, which can be fatal.","Tramadol can cause seizures, especially in patients with a history of seizures or those taking other seizure-threshold-lowering drugs.","Risk of serotonin syndrome when used with serotonergic drugs.","Risk of respiratory depression, especially in elderly or debilitated patients.","May cause physical and psychological dependence.","Do not stop abruptly after prolonged use; taper gradually under medical supervision."]
🤱 Lactation Safety
Ketorolac and tramadol are excreted in breast milk. Breastfeeding is not recommended while taking this medicine due to potential serious adverse effects in the infant. Consult your doctor for alternative options.
💊 Overdose Management
Overdose can cause severe respiratory depression, seizures, gastrointestinal bleeding, and kidney failure. Seek emergency medical attention immediately. Treatment is supportive and may include naloxone for opioid effects, activated charcoal if recent ingestion, and management of seizures and bleeding. Hemodialysis may be considered for ketorolac overdose.
⏰ Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at once to make up for a missed dose.
Additional Safety Advice
Take this medicine exactly as prescribed. Do not exceed the recommended dose or duration. Avoid alcohol and other central nervous system depressants. Do not drive or operate heavy machinery until you know how this medicine affects you. Inform your doctor if you have a history of ulcers, kidney disease, liver disease, or bleeding disorders. Do not use for more than 5 days unless directed by a doctor. Keep out of reach of children. Store at room temperature away from moisture and heat.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients (above 65 years) are at higher risk of gastrointestinal bleeding, kidney impairment, and central nervous system effects such as confusion and falls. Use with caution, and dose reduction may be necessary. Monitor renal function closely.
🤰 Pregnancy Planning (TTC)
This medicine is not recommended during pregnancy, especially in the third trimester, due to risks of premature closure of the ductus arteriosus and potential harm to the fetus. If you are planning pregnancy, consult your doctor to switch to a safer alternative before conception.
🏥 Post-Surgery Considerations
This medicine may be used for short-term postoperative pain management. However, it should be used with caution due to risks of bleeding and kidney impairment. Monitor for signs of bleeding and ensure adequate hydration. Transition to safer analgesics as soon as possible.
🦷 Dental Procedures
This medicine can be used for short-term relief of dental pain, including post-extraction pain. Inform your dentist if you are taking this medicine before any dental procedure, as it may increase bleeding risk. Do not use for more than 5 days.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
Avoid strenuous exercise or activities that require full alertness while taking this medicine, as it can cause drowsiness and dizziness. Gentle stretching or walking may be okay if you feel alert, but consult your doctor first.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine can cause drowsiness, dizziness, and difficulty concentrating, which may affect your ability to drive, operate machinery, or perform tasks requiring alertness. It is advisable to avoid such activities until you know how the medicine affects you. Inform your employer if your job involves safety-sensitive tasks.
🛑 When to Stop This Medicine
Stop taking this medicine as soon as your acute pain is controlled or after the prescribed duration (usually no more than 5 days). Do not stop abruptly if you have been taking it for more than a few days; consult your doctor for a tapering schedule to avoid withdrawal symptoms. Seek medical advice if pain persists or worsens.
📅 Long-Term Use Effects
Long-term use of this medicine is not recommended due to the risk of gastrointestinal bleeding, kidney impairment, liver toxicity, and dependence. If used for more than a few days, regular monitoring of kidney and liver function, as well as blood counts, is advised. Prolonged use may lead to tolerance, withdrawal symptoms, and increased cardiovascular risk. It should be discontinued as soon as acute pain is controlled.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Can complement medicine for musculoskeletal pain and improve function.
Evidence: Well-establishedSafer alternative for mild to moderate pain, especially for short-term use.
Evidence: Well-establishedIce, heat, rest, and elevation can help manage acute pain.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
Not established from the available information. There are no known interactions between this medicine and vaccines. However, consult your doctor before receiving any vaccine while on this medicine.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate unless specified
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
Carry this medicine in its original packaging with a copy of your prescription. Keep it in your carry-on luggage. Store at room temperature and protect from extreme heat or cold. If traveling across time zones, adjust dosing intervals as advised by your doctor. Check local customs regulations regarding controlled substances, as tramadol may be regulated.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: This medicine usually starts relieving pain within 30 to 60 minutes after taking it.
A: It is best taken with food or milk to reduce the risk of stomach upset and gastrointestinal irritation.
A: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double dose.
A: This medicine can cause drowsiness and dizziness. Avoid driving or operating heavy machinery until you know how it affects you.
A: Do not stop suddenly if you have been taking it for more than a few days, as it may cause withdrawal symptoms. Consult your doctor for a tapering schedule.
🤔 Common Patient Concerns
🔄 Substitutes for ketotru tablet
View AllAlternative brands with exact same active ingredient:
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: This medicine is safe for long-term pain management.
Fact: This medicine is only for short-term use (up to 5 days) due to risks of gastrointestinal bleeding, kidney damage, and dependence. - Myth: It is safe to drink alcohol while taking this medicine.
Fact: Alcohol increases the risk of gastrointestinal bleeding and severe sedation, and should be avoided. - Myth: This medicine can be taken without a prescription.
Fact: It is a prescription-only medicine and must be used under medical supervision.
🔄 Alternative Options
Generic Alternatives
- Ketorolac 10 mg + Tramadol 25 mg tablet (generic)
Brand Alternatives
- Ketotram 10mg/25mg tablet