How SPRIX® May Help
SPRIX® (ketorolac tromethamine) Nasal Spray is the first and only intranasal NSAID. It’s indicated for the short-term (up to 5 days) management of moderate to moderately severe pain that requires analgesia at the opioid level. Many of those patients have just been through surgery—when studies show pain can be at its worst.1
Guidelines recommend prompt treatment for pain, with good reason.2,3 Effective non-narcotic pain relief in the early postoperative period may have ongoing benefits.2 For instance, early treatment may promote healing, help prevent sequelae, and help reduce the costs of ongoing healthcare related to pain treatment.4
- Uncontrolled postsurgical pain may compromise recovery because of
- Increased risk of developing chronic pain and severe complications,
such as pneumonia and deep vein thrombosis4
- Impaired mobility and quality of life4
Pain relief when patients need it most
In the critical first 48 hours after surgery, a time when pain can spike with movement and deep breathing,4 SPRIX® treatment led to statistically and clinically significant benefits in acute pain control.1,5
Proven Efficacy in Postoperative Pain, Resulting in Less Morphine Use
The predose pain intensity score, as measured by the Visual Analog Scale (VAS), was 54.1 in the placebo group and 54.7 in the SPRIX® group.1 Pain intensity difference refers to the change with respect to the predose pain intensity value.
A phase 3, randomized, double-blind, placebo-controlled study to evaluate the analgesic efficacy and tolerability of single- and multiple-dose SPRIX® in major abdominal and orthopedic surgery patients remaining in hospital for 2-5 days. Patients were randomly assigned in a 2:1 ratio to receive SPRIX® 31.5 mg or matching placebo following surgery (day 0). All patients had access to morphine sulfate (MS) by patient-controlled analgesia (PCA) beginning on day 0. The study was designed with a multidose regimen of SPRIX® 31.5 mg or matching placebo administered 3 times per day for up to 5 days. Backup analgesia was permitted. Total hysterectomies were the majority of abdominal surgery procedures (87%). Hip replacements were the most common orthopedic procedure (72%). Other procedures were ovarian cystectomy, laminectomy, rotator cuff repair, fracture reduction and fixation, salpingo-oophorectomy, breast reconstruction, appendectomy, and knee and ankle replacement.1
The same study also assessed efficacy of a single-dose regimen without access to backup analgesia as the primary endpoint (SPID6 data presented above). These patients rejoined the multidose phase of the study when pain returned to baseline, or when they requested additional analgesia.1
Pain relief with reduced opioid use
Studies have shown SPRIX® not only provides opioid-level pain relief, but can also reduce the amount of opioids required.1,5
Patients being treated with SPRIX® had access to PCA morphine, yet used 26% to 34% less morphine in the first 48 hours, compared with patients in the placebo groups.
SPRIX® Provided Proven Efficacy in Postoperative Pain, Resulting in Less Morphine Use
Predose Visual Analog Scale (VAS) score was 54.1 in the placebo group and 54.7 in the SPRIX® group. Morphine use reduction was a secondary endpoint.1
A phase 3, randomized, double-blind, placebo-controlled study to evaluate the analgesic efficacy and tolerability of single- and multiple-dose SPRIX® in major abdominal and orthopedic surgery patients remaining in hospital for 2-5 days. Patients were randomly assigned in a 2:1 ratio to receive SPRIX® 31.5 mg or matching placebo following surgery (day 0). All patients had access to morphine sulfate (MS) by patient-controlled analgesia (PCA) beginning on day 0. The study was designed with a multidose regimen of SPRIX® 31.5 mg or matching placebo administered 3 times per day for up to 5 days. Backup analgesia was permitted. Total hysterectomies were the majority of abdominal surgery procedures (87%). Hip replacements were the most common orthopedic procedure (72%). Other procedures were ovarian cystectomy, laminectomy, rotator cuff repair, fracture reduction and fixation, salpingo-oophorectomy, breast reconstruction, appendectomy, and knee and ankle replacement.1
Patients Required Less Morphine as a Result of Greater Pain Relief With SPRIX®
Predose Visual Analog Scale (VAS) score was 60.8 in the placebo group and 62.5 in the SPRIX® group. Morphine use reduction was a secondary endpoint.5
A phase 3, randomized, double-blind, placebo-controlled study to evaluate the analgesic efficacy and tolerability of SPRIX® use after abdominal surgery. Adult patients were randomly assigned to receive SPRIX® 31.5 mg (n=214) or placebo (n=107) every 6 hours after surgery for 48 hours, then up to 4 times/day for up to 5 days. Morphine sulfate via PCA was available through at least 48 hours in both groups as needed. When PCA was no longer required, oral analgesics such as hydrocodone/acetaminophen were permitted for pain as needed.5
Pain relief without narcotics
Nonopioid analgesics are often preferred in ambulatory surgeries, in part because patients return to normal functioning more quickly and avoid opioid-related side effects.5,8
- Ketorolac does not bind to opiate receptors—no CNS effects9
- Patients can return to daily activities without sedation or somnolence9
Helping in the battle against opioid misuse
SPRIX® is a non-narcotic option to consider when patients require short-term (up to five days) treatment of moderate to moderately severe pain. SPRIX® may be an effective option for healthcare providers seeking to comply with the new Prescription Drug Abuse Prevention Plan.10
- SPRIX® prescriptions require no filing with prescription drug monitoring programs
- SPRIX® provides opioid-level analgesia for patients experiencing moderate to moderately severe pain but, because it is an NSAID, it is not associated with opioid-related misuse or diversion