Last Updated: May 13, 2026

CLINICAL TRIALS PROFILE FOR TROMETHAMINE


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505(b)(2) Clinical Trials for tromethamine

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Dosage NCT00266786 ↗ Safety and Efficacy of Multiple Doses of Intranasal Ketorolac in Postoperative Pain Following Major Abdominal Surgery Completed Egalet Ltd Phase 3 2005-12-01 Ketorolac has been marketed for several years in other forms (tablet and injectable) for the short-term relief of pain. This study will test whether a new dosage form (nasal spray) containing ketorolac is effective at relieving the pain of major abdominal surgery, and will also assess product safety. Previous studies with the nasal spray have suggested that it is similar to the previously approved injectable form in effectiveness for pain relief and in its safety profile. Patients will be randomized in a 2:1 ratio to receive intranasal ketorolac or placebo when the pain reaches a moderate level (40 on a scale of 100) following surgery. After the first dose, subjects will receive study drug every 6 hours for 48 hours, and then as needed (up to 4 times a day) for a total of 5 days. If pain is not adequately relieved by the study drug, subjects will be given morphine sulfate or other standard analgesics. Follow-up safety evaluations will occur about 1 and 2 weeks after the start of dosing. Subjects will be asked to answer questions about their pain relief and any possible side effects of the drug during the study, and will be given physical examinations, including nasal evaluations, before and during the clinical trial. A small amount of blood will be drawn for routine clinical laboratory testing.
New Dosage NCT00266786 ↗ Safety and Efficacy of Multiple Doses of Intranasal Ketorolac in Postoperative Pain Following Major Abdominal Surgery Completed Luitpold Pharmaceuticals Phase 3 2005-12-01 Ketorolac has been marketed for several years in other forms (tablet and injectable) for the short-term relief of pain. This study will test whether a new dosage form (nasal spray) containing ketorolac is effective at relieving the pain of major abdominal surgery, and will also assess product safety. Previous studies with the nasal spray have suggested that it is similar to the previously approved injectable form in effectiveness for pain relief and in its safety profile. Patients will be randomized in a 2:1 ratio to receive intranasal ketorolac or placebo when the pain reaches a moderate level (40 on a scale of 100) following surgery. After the first dose, subjects will receive study drug every 6 hours for 48 hours, and then as needed (up to 4 times a day) for a total of 5 days. If pain is not adequately relieved by the study drug, subjects will be given morphine sulfate or other standard analgesics. Follow-up safety evaluations will occur about 1 and 2 weeks after the start of dosing. Subjects will be asked to answer questions about their pain relief and any possible side effects of the drug during the study, and will be given physical examinations, including nasal evaluations, before and during the clinical trial. A small amount of blood will be drawn for routine clinical laboratory testing.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for tromethamine

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00001698 ↗ Randomized, Double Blind, Placebo-Controlled, Phase IIB Trial of Ketorolac Mouth Rinse Evaluating the Effect of Cyclooxygenase Inhibition on Oropharyngeal Leukoplakia: Collaborative Study of the NCI, NIDCD and the NIDCR Completed National Cancer Institute (NCI) Phase 2 1998-06-01 In Phase II trials, treatment with ketorolac tromethamine oral rinse has been shown to block periodontal disease progression even in the absence of standard clinical intervention such as scaling and root planing which is routinely done to reduce the periodontal pathogen load that is driving the local destructive host inflammatory response. Resolution of periodontal disease has a favorable effect on normalizing the cellular and biochemical indices of inflammation as reflected by histological changes as well as the levels of prostaglandin E2 (PGE2) and interleukin I beta (IL-1beta). In this trial, we will prospectively evaluate if eliminating the inflammatory process (via inhibition of PGE2 biosynthesis) in the oral cavity has a favorable impact on reversing oropharyngeal leukoplakia. To test this hypothesis, up to 57 prospectively identified individuals with objective findings of oropharyngeal leukoplakia will be randomized to receive either a mouth rinse containing ketorolac or placebo. Ketorolac is a 7-fold selective inhibitor of cyclooxygenase-2 (Cox-2), which has been designed for local delivery to maximize the drug exposure to critical oral target tissues while minimizing gastric and systemic exposure to the drug. All responses will be determined at the three month completion of trial using the response criteria developed at MD Anderson Cancer Center. The drug will be given for three months and then all the patients will be followed for one additional month off all oral treatment to observe for late side effects. Based on the analysis of oral exam and photographically documented change in the pretreatment area of leukoplakia, the response of all patients will be determined. The evaluation of the outcome will include a measurable secondary endpoint consisting of an assessment of histological change as determined by serial punch biopsies of the oral cavity. In addition, a panel of carcinogenesis and inflammatory markers will be serially measured at baseline, at one month follow up or at study conclusion. In the residual tissue, other bioassays will be evaluated to determine their suitability as intermediate endpoint markers. The purpose of this study is a preliminary evaluation of the effectiveness of ketorolac as a potential chemoprevention agent for oropharyngeal cancer. If ketorolac administration in this preliminary Phase IIB trial is associated with reversal of leukoplakia, then a definitive Phase III chemoprevention trial with a cancer reduction endpoint (most likely in a cooperative group-type setting) may be the next validation step.
NCT00111956 ↗ Effects of Tumor Necrosis Factor (TNF)-Alpha Antagonism in Patients With Metabolic Syndrome Completed Massachusetts General Hospital Phase 2/Phase 3 2004-04-01 Metabolic syndrome is associated with increased inflammatory cytokines and reduced adiponectin, that may be mediated in part by TNF production from abdominal fat. We reasoned that an anti-TNF agent would reduce C-reactive protein (CRP) and increase adiponectin, improving the inflammatory milieu associated with metabolic syndrome.
NCT00111956 ↗ Effects of Tumor Necrosis Factor (TNF)-Alpha Antagonism in Patients With Metabolic Syndrome Completed National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Phase 2/Phase 3 2004-04-01 Metabolic syndrome is associated with increased inflammatory cytokines and reduced adiponectin, that may be mediated in part by TNF production from abdominal fat. We reasoned that an anti-TNF agent would reduce C-reactive protein (CRP) and increase adiponectin, improving the inflammatory milieu associated with metabolic syndrome.
NCT00266786 ↗ Safety and Efficacy of Multiple Doses of Intranasal Ketorolac in Postoperative Pain Following Major Abdominal Surgery Completed Egalet Ltd Phase 3 2005-12-01 Ketorolac has been marketed for several years in other forms (tablet and injectable) for the short-term relief of pain. This study will test whether a new dosage form (nasal spray) containing ketorolac is effective at relieving the pain of major abdominal surgery, and will also assess product safety. Previous studies with the nasal spray have suggested that it is similar to the previously approved injectable form in effectiveness for pain relief and in its safety profile. Patients will be randomized in a 2:1 ratio to receive intranasal ketorolac or placebo when the pain reaches a moderate level (40 on a scale of 100) following surgery. After the first dose, subjects will receive study drug every 6 hours for 48 hours, and then as needed (up to 4 times a day) for a total of 5 days. If pain is not adequately relieved by the study drug, subjects will be given morphine sulfate or other standard analgesics. Follow-up safety evaluations will occur about 1 and 2 weeks after the start of dosing. Subjects will be asked to answer questions about their pain relief and any possible side effects of the drug during the study, and will be given physical examinations, including nasal evaluations, before and during the clinical trial. A small amount of blood will be drawn for routine clinical laboratory testing.
NCT00266786 ↗ Safety and Efficacy of Multiple Doses of Intranasal Ketorolac in Postoperative Pain Following Major Abdominal Surgery Completed Luitpold Pharmaceuticals Phase 3 2005-12-01 Ketorolac has been marketed for several years in other forms (tablet and injectable) for the short-term relief of pain. This study will test whether a new dosage form (nasal spray) containing ketorolac is effective at relieving the pain of major abdominal surgery, and will also assess product safety. Previous studies with the nasal spray have suggested that it is similar to the previously approved injectable form in effectiveness for pain relief and in its safety profile. Patients will be randomized in a 2:1 ratio to receive intranasal ketorolac or placebo when the pain reaches a moderate level (40 on a scale of 100) following surgery. After the first dose, subjects will receive study drug every 6 hours for 48 hours, and then as needed (up to 4 times a day) for a total of 5 days. If pain is not adequately relieved by the study drug, subjects will be given morphine sulfate or other standard analgesics. Follow-up safety evaluations will occur about 1 and 2 weeks after the start of dosing. Subjects will be asked to answer questions about their pain relief and any possible side effects of the drug during the study, and will be given physical examinations, including nasal evaluations, before and during the clinical trial. A small amount of blood will be drawn for routine clinical laboratory testing.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for tromethamine

Condition Name

Condition Name for tromethamine
Intervention Trials
Postoperative Pain 7
Pain 6
Cataract 4
Healthy Volunteers 4
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Condition MeSH

Condition MeSH for tromethamine
Intervention Trials
Pain, Postoperative 16
Cataract 9
Macular Edema 6
Acute Pain 4
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Clinical Trial Locations for tromethamine

Trials by Country

Trials by Country for tromethamine
Location Trials
United States 80
China 16
Brazil 7
United Kingdom 5
Iran, Islamic Republic of 4
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Trials by US State

Trials by US State for tromethamine
Location Trials
California 9
Pennsylvania 7
North Carolina 5
Florida 5
New York 5
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Clinical Trial Progress for tromethamine

Clinical Trial Phase

Clinical Trial Phase for tromethamine
Clinical Trial Phase Trials
PHASE1 4
Phase 4 20
Phase 3 14
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Clinical Trial Status

Clinical Trial Status for tromethamine
Clinical Trial Phase Trials
Completed 63
Unknown status 7
Not yet recruiting 5
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Clinical Trial Sponsors for tromethamine

Sponsor Name

Sponsor Name for tromethamine
Sponsor Trials
Egalet Ltd 11
Luitpold Pharmaceuticals 9
Mateon Therapeutics 4
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Sponsor Type

Sponsor Type for tromethamine
Sponsor Trials
Other 61
Industry 43
NIH 5
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Tromethamine: Clinical Trials Update and Market Outlook

Last updated: April 27, 2026

What is tromethamine and how is it positioned clinically?

Tromethamine (also known as trometamol, tris-hydroxymethyl aminomethane) is a buffering agent used to correct or prevent metabolic acidosis and to support acid-base balance in acute and chronic clinical settings. Commercially, it is marketed under multiple brands globally (formulations and regulatory indications vary by country), and it is commonly delivered as an injectable buffering solution in hospital settings.

In practice, tromethamine is used in therapeutic areas tied to acid-base disorders. The clinical and commercial profile is therefore shaped less by oncology-style long-term trial pipelines and more by:

  • acute-care use patterns,
  • guideline inclusion where applicable,
  • payer coverage for hospital formulary budgets,
  • and competitive positioning versus other alkalinizing/buffering strategies.

What does the current clinical-trials landscape show?

A complete, up-to-date global clinical-trials update for tromethamine requires trial-by-trial extraction from authoritative registries (for example ClinicalTrials.gov, EU CTR, WHO ICTRP). In the information provided in this request, no registry dataset, trial list, or country filter is included, so an accurate, complete clinical update cannot be produced without introducing errors.

Given that constraint, this report does not present a trial-by-trial status table or timelines.

How does the market work for tromethamine?

Demand drivers

Tromethamine demand is tied to hospital and acute-care workflows rather than elective long-duration use. Key drivers typically include:

  • Incidence of metabolic acidosis in inpatient populations
  • ICU utilization and availability of IV buffering protocols
  • Formulary and protocol adoption by health systems
  • Supply continuity and injectable stability logistics
  • Competition from alternative alkalinizing agents and bicarbonate-based regimens (where used)

Typical buyer and purchase pattern

  • Primary buyers: hospital pharmacies and group purchasing organizations
  • Purchase model: tendered/contracted supply, with stocking guided by acute-care demand spikes
  • Procurement: driven by unit economics (cost per treated episode) and availability of injectable supply chains

Competitive dynamics

Tromethamine competes in practice on:

  • Formulation-specific performance (concentration, volume format, stability)
  • Regulatory approvals by indication and patient population
  • Pricing pressure in markets with multiple generic entrants
  • Tender outcomes linked to local contracting rules

Market size: what can be projected from the available inputs?

This request does not include any market baseline (revenue or volume), geography, or formulation split (injectable concentration/pack size), and it does not include a specific indication scope. Without those anchors, any numeric forecast would be fabricated.

For that reason, this report provides a structured projection framework only (no unverifiable toplines), focusing on what is measurable and how to translate it into forecast ranges once baseline data is set.

How should a tromethamine market projection be built (model-ready)?

Use a two-layer model: (1) treatment-episode volume and (2) price per unit, then apply a (3) patient mix/coverage factor.

1) Treatment episode volume (T)

Estimate treated episodes by:

  • inpatient counts by indication proxy (ICU admissions with acidosis)
  • protocol share (fraction treated with IV alkalinizing agent including tromethamine)
  • formulary penetration (fraction of hospitals where tromethamine is stocked)
  • dose intensity (mL or grams per episode)

Generic form:
T = (ICU or inpatient base) × (acidosis proportion) × (protocol adoption share) × (formulary penetration) × (dose conversion)

2) Price per unit (P)

Price is best modeled as:

  • average contract price per pack (tendered)
  • minus substitution effects (formulary switching to alternatives)
  • weighted by concentration and pack size mix

Generic form:
Revenue = T × P

3) Coverage and substitution factor (S)

Capture local variability via:

  • payer coverage rules for acute IV agents
  • hospital preference for competing buffering strategies
  • supply continuity events that change contracting terms

Generic form:
Projected Revenue = Revenue × (1 ± S)

Scenario structure for forecasting

Build three scenarios aligned to how buyers behave:

  • Base case: stable formulary penetration, steady tender pricing
  • Upside case: protocol expansion and new label uptake where applicable
  • Downside case: accelerated substitution to alternatives and tender price compression

Time horizon guidance

Use:

  • 2 years for contract cycle visibility
  • 5 years for clinical/protocol and supply-structure effects

What regulatory and formulation factors affect uptake?

Tromethamine’s uptake is shaped by regulatory approvals by route and indication, and by practical hospital constraints:

  • IV compatibility and administration workflow
  • pack size and dosing flexibility
  • excipient and stability profiles
  • product supply and manufacturing continuity

In markets with multiple entrants, competitive outcomes typically track tender pricing and supply reliability more than novel clinical differentiation.

Investment and R&D implications (where meaningful signal exists)

R&D: where differentiation could matter

If a company is funding new development around tromethamine, the only categories that tend to move prescribing or tender behavior are:

  • a formulation with improved usability (administration, concentration, stability)
  • a distinct clinical use pathway that changes episode volume or hospital protocol inclusion
  • label expansion that increases formulary acceptance in additional patient segments

Commercial: what moves revenue

For tromethamine, revenue growth is most directly linked to:

  • hospital formulary penetration changes
  • contract pricing stability vs generic price erosion
  • episode volume from protocol uptake and guideline adoption in acute settings

Key Takeaways

  • Tromethamine is positioned as an IV buffering agent for metabolic acidosis and acid-base management, with demand driven by hospital protocols and ICU/inpatient episode volumes.
  • A precise, registry-backed clinical trials update cannot be provided from the inputs in this request without risking inaccuracies.
  • A numeric market projection also cannot be produced without baseline market anchors and scope (geography, formulation, indication).
  • The model-ready forecast structure is built on treated-episode volume × contract price per unit × substitution/coverage factor, with base/upside/downside scenarios tied to formulary penetration and tender pricing dynamics.

FAQs

1) What is tromethamine used for?

It is a buffering agent used to correct or prevent metabolic acidosis and support acid-base balance, typically via injectable administration in hospital settings.

2) Who buys tromethamine in commercial markets?

The main buyers are hospitals and health systems, often through group purchasing organizations and tender contracting.

3) What most affects tromethamine revenue?

Hospital formulary penetration, tender pricing, treated episode volume, and substitution versus alternative buffering agents.

4) Is tromethamine a “pipeline” drug in the way oncology drugs are?

Typically no. Demand is driven by acute-care protocols and established use patterns; meaningful growth usually comes from protocol/label expansion or formulation-driven differentiation.

5) What is the fastest way to build a forecast?

Model treated episodes from inpatient/ICU proxies, multiply by contract price per unit, then apply a substitution/coverage factor and run base/upside/downside scenarios over a 2- to 5-year horizon.


References

[1] ClinicalTrials.gov. (n.d.). Tromethamine search results. U.S. National Library of Medicine. https://clinicaltrials.gov/
[2] EU Clinical Trials Register. (n.d.). Tromethamine search results. European Medicines Agency. https://www.clinicaltrialsregister.eu/
[3] WHO International Clinical Trials Registry Platform (ICTRP). (n.d.). Tromethamine search results. World Health Organization. https://trialsearch.who.int/

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