Toradol: 7 things you should know
Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 20, 2023.
1. How it works
- Toradol is a brand (trade) name for ketorolac which may be used to treat acute, moderately severe pain that occurs following surgery.
- Toradol (ketorolac) helps to relieve pain and inflammation by blocking the effects of the enzymes cyclo-oxygenase (COX)-1 and COX-2. This prevents prostaglandin synthesis (prostaglandins elevate body temperature and make nerve endings more sensitive to pain transmission).
- Toradol belongs to a group of medicines known as nonsteroidal anti-inflammatory drugs (NSAIDs).
- The Toradol brand name has been discontinued in the U.S. but generic equivalents under the name of ketorolac are still available. This patient tip is retained for information purposes only.
- 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.
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 the 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 or 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 bleeding. Never use it as a prophylactic analgesic before major surgery.
- May interact with several 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.
- NSAIDs, such as Toradol, should not be used during the last three months of pregnancy because they can cause premature closure of the fetal ductus arteriosus. In addition, the use of NSAIDs at around 20 weeks gestation or later in pregnancy may cause fetal kidney problems leading to oligohydramnios (low amniotic fluid volume) and in some cases kidney impairment. If NSAID treatment is deemed necessary between 20 and 30 weeks of pregnancy, use the lowest effective dose for the shortest possible time. Avoid NSAIDs after 30 weeks gestation.
Note: 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. View complete list of side effects
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. The Toradol brand name has been discontinued in the U.S. but generic equivalents under the name of ketorolac are still available.
- 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.
- NSAIDs, such as Toradol, should not be used in the last 3 months of pregnancy; always ask your doctor before using any medication during pregnancy. Do not use NSAIDs such as Toradol between 20 and 30 weeks gestation without your doctor's advice because this may cause kidney problems and low amniotic fluid volumes in the newborn. Occasional acetaminophen may be considered to treat pain and inflammation during pregnancy.
6. Response and effectiveness
- Peak concentrations of Toradol are reached within two to three hours.
Medicines that interact with Toradol may either decrease its effect, affect how long it works, 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,
- 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
- nonsteroidal anti-inflammatories, such as diclofenac, ibuprofen, indomethacin, naproxen
- 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.
More about Toradol (ketorolac)
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- Side effects
- Dosage information
- During pregnancy
- Support group
- Drug class: Nonsteroidal anti-inflammatory drugs
Related treatment guides
- Toradol (ketorolac) [Package Insert] Revised 03/2023. Genentech, Inc https://www.drugs.com/pro/toradol.html
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.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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