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Ketorolac, sold under the brand name Toradol among others, is a nonsteroidal anti-inflammatory drug (NSAID) in the family of heterocyclic acetic acid derivatives, used as an analgesic.[1][2] It is considered a first-generation NSAID.[3] Ketorolac
Ketorolac
acts by inhibiting the bodily synthesis of prostaglandins. Ketorolac
Ketorolac
in its oral (tablet or capsule) and intramuscular (injected) preparations is a racemic mixture of both (S)-(−)-ketorolac, the active isomer, and (R)-(+)-ketorolac.[3] Ketorolac
Ketorolac
was developed in 1989 by Syntex Corp. (now part of Roche).[4] It was approved for medical use in the United States in 1989.[5] The eye-drop formulation was approved by the FDA in 1992.[6] An intranasal formulation was approved by the FDA in 2010[7] for short-term management of moderate to moderately severe pain requiring analgesia at the opioid level. As of 2015, the cost for a typical course of medication in the United States is less than US$25.[8]

Contents

1 Medical uses 2 Contraindications 3 Adverse effects 4 Interactions 5 Mechanism of action 6 History 7 References 8 Bibliography 9 External links

Medical uses[edit] Ketorolac
Ketorolac
is used for short-term management of moderate to severe pain. It is usually not prescribed for longer than five days.[1][2][9][10] Ketorolac
Ketorolac
is effective when administered with paracetamol to control pain in neonates because it does not depress respiration as do opioids.[11] Ketorolac
Ketorolac
is also an adjuvant to opioid medications and improves pain relief. It is also used to treat dysmenorrhea.[10] Ketorolac
Ketorolac
is used to treat idiopathic pericarditis, where it reduces inflammation.[12] Ketorolac
Ketorolac
is used for short-term pain control not lasting longer than five days, and can be administered orally, by intramuscular injection, intravenously, and by nasal spray.[1] Ketorolac
Ketorolac
is initially administered by intramuscular injection or intravenously. Oral therapy is only used as a continuation from the intramuscular or intravenous starting point.[1][11] Ketorolac
Ketorolac
is used during eye surgery to maintain mydriasis, or the 'relaxing' of the iris muscles that will allow surgeons to perform cataract surgery.[13] Ketorolac
Ketorolac
is effective in treating ocular itching.[14] The ketorolac ophthalmic formulation is associated with a decreased development of macular edema after cataract surgery and is more effective alone rather than as an opioid/ketorolac combination treatment.[15][16] Ketorolac
Ketorolac
has also been used to manage pain from corneal abrasions.[17] During treatment with ketorolac, clinicians monitor for the manifestation of adverse effects and side effects. Lab tests, such as liver function tests, bleeding time, BUN, serum creatinine and electrolyte levels are often used and help to identify potential complications.[1][2] Contraindications[edit] Ketorolac
Ketorolac
is contraindicated in those with hypersensitivity, allergies to the medication, cross-sensitivity to other NSAIDs, prior to surgery, history of peptic ulcer disease, gastrointestinal bleeding, alcohol intolerance, renal impairment, cerebrovascular bleeding, nasal polyps, angioedema, and asthma.[1][2] Recommendations exist for cautious use of ketorolac in those who have experienced cardiovascular disease, myocardial infarction, stroke, heart failure, coagulation disorders, renal impairment, and hepatic impairment.[1][2] Adverse effects[edit] Though uncommon, potentially fatal adverse effects are stroke, myocardial infarction, GI bleeding, Stevens-Johnson Syndrome, toxic epidermal necrolysis and anaphylaxis. A less serious and more common (>10%) side effect is drowsiness. Infrequent (<1%) side effects are paresthesia, prolonged bleeding time, injection site pain, purpura, sweating, abnormal thinking, increased production of tears, edema, pallor, dry mouth, abnormal taste, urinary frequency, increased liver enzymes, itching and others. Ketorolac
Ketorolac
can cause premature constriction of the ductus arteriosis in an infant during the third trimester of pregnancy.[1][2] Platelet function is decreased related to the use of ketorolac.[3] The practice of restricting treatment with ketorolac is due to its potential to cause kidney damage.[18] Interactions[edit] Ketorolac
Ketorolac
can interact with other medications. Probenecid
Probenecid
can increase the probability of having an adverse reaction or experiencing a side effect when taken with ketorolac. Pentoxifylline
Pentoxifylline
can increase the risk of bleeding. When aspirin is taken at the same time as ketorolac, the effectiveness is decreased. Problematic GI effects are additive and become more likely if potassium supplements, aspirin, other NSAIDS, corticosteroids, or alcohol is taken at the same time. The effectiveness of antihypertensives and diuretics can be lowered. The use of ketorolac can increase serum lithium levels to the point of toxicity. Toxicity to methotrexate is more likely if ketorolac is taken at the same time. The risk of bleeding increases with the concurrent medications clopidogrel, cefoperazone, valproic acid, cefotetan, eptifibatide, tirofiban, and copidine. Anticoagulants and thrombolytic medications also increase the likelihood of bleeding. Medications used to treat cancer can interact with ketorolac along with radiation therapy. The risk of toxicity to the kidneys increases when ketorolac is taken with cyclosporine.[1][2] Interactions with ketorolac exist with some herbal supplements. Panax ginseng, clove, ginger, arnica, feverfew, dong quai, chamomile, and Ginkgo biloba, increases the risk of bleeding.[1][2] Mechanism of action[edit] The primary mechanism of action responsible for ketorolac's anti-inflammatory, antipyretic and analgesic effects is the inhibition of prostaglandin synthesis by competitive blocking of the enzyme cyclooxygenase (COX). Ketorolac
Ketorolac
is a non-selective COX inhibitor.[19] Ketorolac
Ketorolac
has been assessed to be a relatively higher risk NSAID when compared to aceclofenac, celecoxib, and ibuprofen.[12] History[edit] In the US, ketorolac was the only widely available intravenous NSAID for many years; an IV form of paracetemol, which is not an NSAID, became available in Europe in 2009 and then in the US.[11] The Syntex company, of Palo Alto, California
Palo Alto, California
developed the ophthalmic solution Acular around 2006.[citation needed] In 2007, there were concerns about the high incidence of reported side effects. This led to restriction in its dosage and maximum duration of use. In the UK, treatment was initiated only in a hospital. Dosing guidelines were published at that time.[20] Concerns over the high incidence of reported side effects with ketorolac trometamol led to its withdrawal (apart from the ophthalmic formulation) in several countries, while in others its permitted dosage and maximum duration of treatment have been reduced. From 1990 to 1993, 97 reactions with a fatal outcome were reported worldwide.[21] References[edit]

^ a b c d e f g h i j Vallerand, April H. (2017). Davis's Drug Guide for Nurses. Philadelphia: F.A. Davis Company. p. 730. ISBN 9780803657052.  ^ a b c d e f g h Physician's Desk Reference 2017. Montvale, New Jersey: PDR, LLC. 2017. pp. S–474–5. ISBN 9781563638381.  ^ a b c Henry, p. 279. ^ "History of Roche Bioscience – FundingUniverse". Fundinguniverse.com. Retrieved 2013-10-06.  ^ " Ketorolac
Ketorolac
medical facts from". Drugs.com. Retrieved 2013-10-06.  ^ " Ketorolac
Ketorolac
ophthalmic medical facts from". Drugs.com. Retrieved 2013-10-06.  ^ "Sprix Information from". Drugs.com. Retrieved 2013-10-06.  ^ Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 9. ISBN 9781284057560.  ^ "Ketorolac-tromethamine". The American Society of Health-System Pharmacists. Retrieved 3 April 2011.  ^ a b Henry, p. 291. ^ a b c Martin, Lizabeth D; Jimenez, Nathalia; Lynn, Anne M (2017). "A review of perioperative anesthesia and analgesia for infants: updates and trends to watch". F1000Research. 6: 120. doi:10.12688/f1000research.10272.1. ISSN 2046-1402. PMC 5302152 . PMID 28232869.  ^ a b Schwier, Nicholas; Tran, Nicole (2016). "Non-Steroidal Anti-Inflammatory Drugs and Aspirin
Aspirin
Therapy for the Treatment of Acute and Recurrent Idiopathic Pericarditis". Pharmaceuticals. 9 (2): 17. doi:10.3390/ph9020017. ISSN 1424-8247.  ^ Saenz-de-Viteri, Manuel; Gonzalez-Salinas, Roberto; Guarnieri, Adriano; Guiaro-Navarro, María Concepción (2016). "Patient considerations in cataract surgery – the role of combined therapy using phenylephrine and ketorolac". Patient Preference and Adherence. Volume 10: 1795–1801. doi:10.2147/PPA.S90468. ISSN 1177-889X.  ^ Karch, Amy (2017). Focus on nursing pharmacology. Philadelphia: Wolters Kluwer. p. 272. ISBN 9781496318213.  ^ Lim, Blanche X; Lim, Chris HL; Lim, Dawn K; Evans, Jennifer R; Bunce, Catey; Wormald, Richard; Wormald, Richard (2016). "Prophylactic non-steroidal anti-inflammatory drugs for the prevention of macular oedema after cataract surgery". Cochrane Database Syst Rev. 11: CD006683. doi:10.1002/14651858.CD006683.pub3. PMID 27801522.  ^ Sivaprasad, Sobha; Bunce, Catey; Crosby-Nwaobi, Roxanne; Sivaprasad, Sobha (2012). "Non-steroidal anti-inflammatory agents for treating cystoid macular oedema following cataract surgery". Cochrane Database Syst Rev (2): CD004239. doi:10.1002/14651858.CD004239.pub3. PMID 22336801.  ^ Wakai A, Lawrenson JG, Lawrenson AL, Wang Y, Brown MD, Quirke M, Ghandour O, McCormick R, Walsh CD, Amayem A, Lang E, Harrison N (2017). "Topical non-steroidal anti-inflammatory drugs for analgesia in traumatic corneal abrasions". Cochrane Database Syst Rev. 5: CD009781. doi:10.1002/14651858.CD009781.pub2. PMID 28516471. CS1 maint: Uses authors parameter (link) ^ Henry, p. 280. ^ Lee, I. O.; Seo, Y. (2008). "The Effects of Intrathecal Cyclooxygenase-1, Cyclooxygenase-2, or Nonselective Inhibitors on Pain Behavior and Spinal Fos-Like Immunoreactivity". Anesthesia & Analgesia. 106 (3): 972–977, table 977 contents. doi:10.1213/ane.0b013e318163f602. PMID 18292448.  ^ MHRA Drug Safety Update October 2007, Volume 1, Issue 3, pp 3-4. ^ Committee on the Safety of Medicines, Medicines Control Agency: Ketorolac: new restrictions on dose and duration of treatment. Current Problems in Pharmacovigilance: June 1993; Volume 19 (pages 5-8).

Bibliography[edit]

AHFS drug information. Bethesda, MD: American Society of Health-System Pharmacists. 2011. ISBN 9781585282609.  Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 9. ISBN 9781284057560.  Handley, Dean A.; Cervoni, Peter; McCray, John E.; McCullough, John R. (1998). "Preclinical enantioselective pharmacology of (R)- and (S)- ketorolac". J Clin Pharmacol. 38 (2 Suppl): 25S–35S. doi:10.1002/j.1552-4604.1998.tb04414.x. ISSN 0091-2700. PMID 9549656.  Henry, Norma (2016). RN pharmacology for nursing : review module. Overland Park, KS: Assessment Technologies Institute. ISBN 9781565335738.  Kizior, Robert (2017). Saunders nursing drug handbook 2017. St. Louis, MO: Elsevier. ISBN 9780323442916. 

External links[edit]

cme.medscape.com on nasal ketorolac, accessed March 30, 2017

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Analgesics (N02A, N02B)

Opioids

Opiates/opium

Codeine# (+paracetamol, +aspirin) Morphine# (+naltrexone) Opium Laudanum Paregoric

Semisynthetic

Acetyldihydrocodeine Benzylmorphine Buprenorphine
Buprenorphine
(+naloxone) Desomorphine Diamorphine (heroin) Dihydrocodeine
Dihydrocodeine
(+paracetamol) Dihydromorphine Ethylmorphine Hydrocodone
Hydrocodone
(+paracetamol, +ibuprofen, +aspirin) Hydromorphinol Hydromorphone Nicocodeine Nicodicodeine Nicomorphine Oxycodone
Oxycodone
(+paracetamol, +aspirin, +ibuprofen, +naloxone, +naltrexone) Oxymorphone Thebacon

Synthetic

Alfentanil Alphaprodine Anileridine Butorphanol Carfentanil Dextromoramide Dextropropoxyphene Dezocine Fentanyl# (+fluanisone) Ketobemidone Levorphanol Lofentanil Meptazinol Methadone# Nalbuphine NFEPP Pentazocine Pethidine
Pethidine
(meperidine) Phenadoxone Phenazocine Piminodine Piritramide Propiram Remifentanil Sufentanil Tapentadol Tilidine Tramadol

Paracetamol-type

Acetanilide‡ Bucetin‡ Butacetin‡ Paracetamol
Paracetamol
(acetaminophen)# Parapropamol‡ Phenacetin‡ Propacetamol‡

NSAIDs

Propionates

Fenoprofen Flurbiprofen Ibuprofen# Ketoprofen Naproxen Oxaprozin

Oxicams

Meloxicam Piroxicam

Acetates

Diclofenac Indometacin Ketorolac Nabumetone Sulindac Tolmetin

COX-2 inhibitors

Celecoxib Etoricoxib Lumiracoxib Parecoxib Rofecoxib
Rofecoxib
Valdecoxib
Valdecoxib

Fenamates

Meclofenamic acid Mefenamic acid

Salicylates

Aspirin
Aspirin
(acetylsalicylic acid)# (+paracetamol/caffeine) Benorylate Diflunisal Ethenzamide Magnesium salicylate Salicin Salicylamide Salsalate Wintergreen
Wintergreen
(methyl salicylate)

Pyrazolones

Aminophenazone‡ Ampyrone Metamizole
Metamizole
(dipyrone) Nifenazone Phenazone Propyphenazone
Propyphenazone
(+paracetamol/caffeine)

Others

Glafenine

Cannabinoids

Cannabidiol Cannabis Nabilone Nabiximols Tetrahydrocannabinol
Tetrahydrocannabinol
(dronabinol)

Ion channel modulators

Calcium blockers

Gabapentin Gabapentin
Gabapentin
enacarbil Pregabalin Ziconotide

Sodium blockers

Carbamazepine Lacosamide Local anesthetics (e.g., cocaine, lidocaine) Mexiletine Nefopam Tricyclic antidepressants (e.g., amitriptyline#)

Nav1.7/1.8-selective: DSP-2230§ Funapide§ PF-05089771§ Raxatrigine§

Potassium openers

Flupirtine

Myorelaxants

Carisoprodol Chlorzoxazone Cyclobenzaprine Mephenoxalone Methocarbamol Orphenadrine

Others

Analgesic
Analgesic
adjuvant Analgecine Camphor Capsaicin Clonidine Ketamine Menthol Methoxyflurane Nefopam Proglumide Tricyclic antidepressants (e.g., amitriptyline#)

#WHO-EM ‡Withdrawn from market Clinical trials:

†Phase III §Never to phase III

v t e

Nonsteroidal anti-inflammatory drugs (NSAIDs) (primarily M01A and M02A, also N02BA)

Pyrazolones / Pyrazolidines

Aminophenazone Ampyrone Azapropazone Clofezone Difenamizole Famprofazone Feprazone Kebuzone Metamizole Mofebutazone Morazone Nifenazone Oxyphenbutazone Phenazone Phenylbutazone Propyphenazone Sulfinpyrazone Suxibuzone‡

Salicylates

Aspirin
Aspirin
(acetylsalicylic acid)# Aloxiprin Benorylate Carbasalate calcium Diflunisal Dipyrocetyl Ethenzamide Guacetisal Magnesium salicylate Methyl salicylate Salsalate Salicin Salicylamide Salicylic acid
Salicylic acid
(salicylate) Sodium salicylate

Acetic acid
Acetic acid
derivatives and related substances

Aceclofenac Acemetacin Alclofenac Amfenac Bendazac Bromfenac Bumadizone Bufexamac Diclofenac Difenpiramide Etodolac Felbinac Fenclozic acid Fentiazac Indometacin Indometacin
Indometacin
farnesil Isoxepac Ketorolac Lonazolac Oxametacin Prodolic acid Proglumetacin Sulindac Tiopinac Tolmetin Zomepirac†

Oxicams

Ampiroxicam Droxicam Isoxicam Lornoxicam Meloxicam Piroxicam Tenoxicam

Propionic acid
Propionic acid
derivatives (profens)

Alminoprofen Benoxaprofen† Carprofen‡ Dexibuprofen Dexketoprofen Fenbufen Fenoprofen Flunoxaprofen Flurbiprofen Ibuprofen# Ibuproxam Indoprofen† Ketoprofen Loxoprofen Miroprofen Naproxen Oxaprozin Pirprofen Suprofen Tarenflurbil Tepoxalin‡ Tiaprofenic acid Vedaprofen‡ COX-inhibiting nitric oxide donator: Naproxcinod

N-Arylanthranilic acids (fenamates)

Azapropazone Clonixin Etofenamate Flufenamic acid Flunixin Meclofenamic acid Mefenamic acid Morniflumate Niflumic acid Tolfenamic acid Flutiazin

Coxibs

Apricoxib Celecoxib Cimicoxib‡ Deracoxib‡ Etoricoxib Firocoxib‡ Lumiracoxib† Mavacoxib‡ Parecoxib Robenacoxib‡ Rofecoxib† Valdecoxib†

Other

Aminopropionitrile Benzydamine Chondroitin sulfate Diacerein Fluproquazone Glucosamine Glycosaminoglycan Hyperforin Nabumetone Nimesulide Oxaceprol Proquazone Superoxide dismutase/Orgotein Tenidap

Items listed in bold indicate initially developed compounds of specific groups. #WHO-EM †Withdrawn drugs. ‡Veterinary use medications.

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Prostanoid
Prostanoid
signaling modulators

Receptor (ligands)

DP (D2)

DP1

Agonists: Prostaglandin
Prostaglandin
D2 Treprostinil

Antagonists: Asapiprant Laropiprant Vidupiprant

DP2

Agonists: Indometacin Prostaglandin
Prostaglandin
D2

Antagonists: ADC-3680 AZD-1981 Bay U3405 Fevipiprant MK-1029 MK-7246 QAV-680 Ramatroban Setipiprant Timapiprant TM30089 Vidupiprant

EP (E2)

EP1

Agonists: Beraprost Enprostil Iloprost
Iloprost
(ciloprost) Latanoprost Lubiprostone Misoprostol Prostaglandin
Prostaglandin
E1 (alprostadil) Prostaglandin
Prostaglandin
E2 (dinoprostone) Sulprostone

Antagonists: AH-6809 ONO-8130 SC-19220 SC-51089 SC-51322

EP2

Agonists: Butaprost Misoprostol Prostaglandin
Prostaglandin
E1 (alprostadil) Prostaglandin
Prostaglandin
E2 (dinoprostone) Treprostinil

Antagonists: AH-6809 PF-04418948 TG 4-155

EP3

Agonists: Beraprost Carbacyclin Cicaprost Enprostil Iloprost
Iloprost
(ciloprost) Isocarbacyclin Latanoprost Misoprostol Prostaglandin
Prostaglandin
D2 Prostaglandin
Prostaglandin
E1 (alprostadil) Prostaglandin
Prostaglandin
E2 (dinoprostone) Remiprostol Sulprostone

Antagonists: L-798106

EP4

Agonists: Lubiprostone Misoprostol Prostaglandin
Prostaglandin
E1 (alprostadil) Prostaglandin
Prostaglandin
E2 (dinoprostone) TCS-2510

Antagonists: Grapiprant GW-627368 L-161982 ONO-AE3-208

Unsorted

Agonists: 16,16-Dimethyl Prostaglandin
Prostaglandin
E2 Aganepag Carboprost Evatanepag Gemeprost Nocloprost Omidenepag Prostaglandin
Prostaglandin
F2α (dinoprost) Simenepag Taprenepag

FP (F2α)

Agonists: Alfaprostol Bimatoprost Carboprost Cloprostenol Enprostil Fluprostenol Latanoprost Prostaglandin
Prostaglandin
D2 Prostaglandin
Prostaglandin
F2α (dinoprost) Sulotroban Tafluprost Travoprost Unoprostone

IP (I2)

Agonists: ACT-333679 AFP-07 Beraprost BMY-45778 Carbacyclin Cicaprost Iloprost
Iloprost
(ciloprost) Isocarbacyclin MRE-269 NS-304 Prostacyclin
Prostacyclin
(prostaglandin I2, epoprostenol) Prostaglandin
Prostaglandin
E1 (alprostadil) Ralinepag Selexipag Taprostene TRA-418 Treprostinil

Antagonists: RO1138452

TP (TXA2)

Agonists: Carbocyclic thromboxane A2 I-BOP Thromboxane A2 U-46619 Vapiprost

Antagonists: 12-HETE 13-APA AA-2414 Argatroban Bay U3405 BMS-180,291 Daltroban Domitroban EP-045 GR-32191 ICI-185282 ICI-192605 Ifetroban Imitrodast L-655240 L-670596 Linotroban Mipitroban ONO-3708 ONO-11120 Picotamide Pinane thromboxane A2 Ramatroban Ridogrel S-145 Samixogrel Seratrodast SQ-28,668 SQ-29,548 Sulotroban Terbogrel Terutroban TRA-418

Unsorted

Arbaprostil Ataprost Ciprostene Clinprost Cobiprostone Delprostenate Deprostil Dimoxaprost Doxaprost Ecraprost Eganoprost Enisoprost Eptaloprost Esuberaprost Etiproston Fenprostalene Flunoprost Froxiprost Lanproston Limaprost Luprostiol Meteneprost Mexiprostil Naxaprostene Nileprost Nocloprost Ornoprostil Oxoprostol Penprostene Pimilprost Piriprost Posaraprost Prostalene Rioprostil Rivenprost Rosaprostol Spiriprostil Tiaprost Tilsuprost Tiprostanide Trimoprostil Viprostol

Enzyme (inhibitors)

COX (PTGS)

Salicylic acids: Aloxiprin Aspirin
Aspirin
(acetylsalicylic acid) Benorilate
Benorilate
(benorylate) Carbasalate calcium Diflusinal Dipyrocetyl Ethenzamide Guacetisal Magnesium salicylate Mesalazine
Mesalazine
(5-aminosalicylic acid) Methyl salicylate Salacetamide Salicin Salicylamide Salicylate
Salicylate
(salicylic acid) Salsalate Sodium salicylate Triflusal; Acetic acids: Aceclofenac Acemetacin Aclofenac Amfenac Alclofenac Bendazac Bromfenac Bufexamac Bumadizone Cinmetacin Clometacin Diclofenac Difenpiramide Etodolac Felbinac Fenclofenac Fentiazac Glucametacin Indometacin
Indometacin
(indomethacin) Indometacin
Indometacin
farnesil Ketorolac Lonazolac Mofezolac Nabumetone Oxametacin Oxindanac Proglumetacin Sulindac Sulindac
Sulindac
sulfide Tolmetin Zidometacin Zomepirac; Propionic acids: Alminoprofen Benoxaprofen Bucloxic acid (blucloxate) Butibufen Carprofen Dexibuprofen Dexindoprofen Dexketoprofen Fenbufen Fenoprofen Flunoxaprofen Flurbiprofen Ibuprofen Ibuproxam Indoprofen Ketoprofen Loxoprofen Miroprofen Naproxen Naproxcinod Oxaprozin Pirprofen Pranoprofen Suprofen Tarenflurbil Tepoxalin Tiaprofenic acid
Tiaprofenic acid
(tiaprofenate) Vedaprofen; Anthranilic acids (fenamic acids): Etofenamic acid (etofenamate) Floctafenic acid (floctafenate) Flufenamic acid
Flufenamic acid
(flufenamate) Meclofenamic acid
Meclofenamic acid
(meclofenamate) Mefenamic acid
Mefenamic acid
(mefenamate) Morniflumic acid (morniflumate) Niflumic acid
Niflumic acid
(niflumate) Talinflumic acid (talinflumate) Tolfenamic acid
Tolfenamic acid
(tolfenamate); Pyrazolones: Azapropazone Dipyrone Isopyrin Oxyphenbutazone Phenylbutazone; Enolic acids (oxicams): Ampiroxicam Droxicam Enolicam Isoxicam Lornoxicam Meloxicam Piroxicam Tenoxicam; 4-Aminoquinolines: Antrafenine Floctafenine Glafenine; Quinazolines: Fluproquazone Proquazone; Aminonicotinic acids: Clonixeril Clonixin Flunixin; Sulfonanilides: Flosulide Nimesulide; Aminophenols (anilines): Acetanilide AM-404 (N-arachidonoylaminophenol) Bucetin Paracetamol
Paracetamol
(acetaminophen) Parapropamol Phenacetin Propacetamol; Selective COX-2 inhibitors (coxibs): Apricoxib Celecoxib Cimicoxib Deracoxib Etoricoxib Firocoxib Lumiracoxib Mavacoxib Parecoxib Polmacoxib Robenacoxib Rofecoxib Tilmacoxib Valdecoxib; Others/unsorted: Anitrazafen Clobuzarit Curcumin DuP-697 FK-3311 Flumizole FR-122047 Glimepiride Hyperforin Itazigrel L-655240 L-670596 Licofelone Menatetrenone
Menatetrenone
(vitamin K2) NCX-466 NCX-4040 NS-398 Pamicogrel Resveratrol Romazarit Rosmarinic acid Rutecarpine Satigrel SC-236 SC-560 SC-58125 Tenidap Tiflamizole Timegadine Trifenagrel Tropesin

PGD2S

Retinoids Selenium
Selenium
(selenium tetrachloride, sodium selenite, selenium disulfide)

PGES

HQL-79

PGFS

Bimatoprost

PGI2S

Tranylcypromine

TXAS

Camonagrel Dazmegrel Dazoxiben Furegrelate Isbogrel Midazogrel Nafagrel Nicogrelate Ozagrel Picotamide Pirmagrel Ridogrel Rolafagrel Samixogrel Terbogrel U63557A

Others

Precursors: Linoleic acid γ-Linolenic acid (gamolenic acid) Dihomo-γ-linolenic acid Diacylglycerol Arachidonic acid Prostaglandin
Prostaglandin
G2 Prostaglandin
Prostaglandin
H2

See also Receptor/signaling modulators Leukotriene signaling modulators Nuclear recepto

.