Sprix

Drug - Sprix (ketorolac) nasal spray [Roxro Pharma]

July 2011

Therapeutic Area - Pain

FDA approved indication

Indicated for short-term (up to five days) management of moderate to moderately severe pain that requires analgesia at the opioid level.

The usual dosage is 31.5 mg (one 15.75 mg spray in each nostril) every six to eight hours. The maximum daily dose is 136 mg. Sprix nasal spray should not be used for longer than five days. Longer use increases the risk of serious complications including gastrointestinal bleeding and renal injury.

Criteria

• Patient is status-post surgery AND
• Patient is on at least one other opiate (e.g., morphine, oxycodone, hydrocodone) for their post-op pain AND
• The patient cannot take oral NSAIDs by mouth (e.g., jaw is wired shut, abdominal surgery)

Quantity limit

A quantity limit of 5 bottles (one per day) applies. This is a safety consideration, and more than five bottles will not be approved.

Rationale

Efficacy data shows that Sprix, used for 2 days, added to morphine after elective surgery, worked better than morphine alone to improve pain scores. Yet, Sprix represents a costly dose formulation of ketorolac.

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411