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Toradol: 7 things you should know

Medically reviewed by C. Fookes, BPharm. Last updated on Feb 18, 2019.

1. How it works

  • Toradol is a brand (trade) name for ketorolac. Ketorolac helps to relieve pain and inflammation by blocking the effects of the enzymes cyclo-oxygenase (COX)-1 and COX-2.
  • Ketorolac belongs to a group of medicines known as nonsteroidal anti-inflammatory drugs (NSAIDs).

2. Upsides

  • Effective for the short-term (up to five days) relief of moderate-to-severe acute pain. Usually reserved for pain that requires analgesia at the opioid level, such as that following surgery.
  • May be used in combination with opioids for superior pain relief.
  • Toradol tablets are usually only used as continuation therapy following IV or IM dosing of injectable ketorolac (the total duration of injectable ketorolac and oral Toradol should not exceed five days).
  • Toradol is available as a generic under the name ketorolac.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Dyspepsia, abdominal pain and headache are most common side effects. Other side effects include flatulence, dizziness, high blood pressure, sweating, rashes, tinnitus and other gastrointestinal upsets.
  • Stomach-related adverse effects such as bleeding, ulceration, and perforation which may be fatal are more likely to happen with Toradol than with most other NSAIDs. Older patients or those taking other medicines that affect the stomach are at a greater risk. Should not be used by people with active peptic ulcer disease or gastrointestinal bleeding. Combining with alcohol may increase the risk of stomach ulcers or bleeding.
  • Should not be used to treat mild pain nor long-standing or chronic pain.
  • Not indicated for pediatric patients.
  • NSAIDs (such as Toradol) have been associated with an increased risk of stroke or heart attack. The risk may be higher in patients with pre-existing conditions and at higher dosages. Avoid Toradol during or after coronary artery bypass (CABG) surgery.
  • May affect kidney function and should not be used by people with moderate-to-severe kidney problems or in those who are dehydrated.
  • Can affect blood clotting so should not be used in patients with or at high risk of a bleeding. Never use as a prophylactic analgesic before major surgery.
  • May interact with a number of other drugs and should never be taken at the same time as other NSAIDs such as aspirin or ibuprofen.
  • Dosage may need adjusting in people over the age of 65 or under 50kg in body weight or with mild kidney dysfunction.
  • Avoid in patients with asthma or who report allergic-type reactions after taking aspirin or other NSAIDs. Caution in patients with inflammatory bowel diseases.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

4. Bottom Line

  • Toradol is a very strong NSAID that should only be considered for the short-term relief of acute, moderately-severe pain that occurs following surgery. Toradol carries a high risk of severe gastrointestinal side effects and can increase bleeding. Treatment with Toradol should not exceed five days.

5. Tips

  • Use only the lowest dose for the shortest possible length of time. Do not take more frequently than every four to six hours. Do not exceed the upper daily dosage maximum of 40mg - additional pain-relieving effects of Toradol are doubtful and serious adverse effects are more likely.
  • Take oral tablets with food to reduce stomach-related adverse effects.
  • Do not take Toradol for longer than five days. Your doctor should switch you to an alternative analgesic as soon as possible.
  • Toradol may make your skin more sensitive to the sun; wear sunblock SPF 30-50+ when outside; see a doctor as soon as possible if you develop a skin rash.
  • If you have experienced asthma-like symptoms, developed hives (urticaria) or other allergic-type reactions in the past after taking aspirin or other NSAIDs (like ibuprofen), do not take Toradol.
  • Combining Toradol with alcohol may increase the risk of developing a stomach ulcer or bleeding from your stomach.

6. Response and Effectiveness

  • Peak concentrations of Toradol are reached within two to three hours.

7. Interactions

Medicines that interact with Toradol may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Toradol. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed. Common medications that may interact with Toradol include:

  • antidepressants, such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline,
  • aspirin
  • diuretics, such as furosemide, hydrochlorothiazide, or chlorthalidone
  • epilepsy medications, such as carbamazepine, oxcarbazepine, phenobarbital, phenytoin, or primidone
  • heart medications, such as candesartan, captopril, enalapril, irbesartan, or losartan
  • lithium
  • methotrexate
  • nonsteroidal anti-inflammatories, such as diclofenac, ibuprofen, indomethacin, naproxen
  • probenecid
  • warfarin
  • others, such as alprazolam, pentoxifylline, muscle relaxants, or thiothixene

Note that this list is not all-inclusive and includes only common medications that may interact with Toradol. You should refer to the prescribing information for Toradol for a complete list of interactions.

References

Toradol (ketorolac) [Package Insert] Revised 04/2018. Genentech, Inc https://www.drugs.com/pro/toradol.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Toradol only for the indication prescribed.

Copyright 1996-2019 Drugs.com. Revision date: February 18, 2019.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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