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Ketorolac tromethamine

Overview

Toradol is a pain reliever in the class of medications commonly called NSAIDs or nonsteroidal anti-inflammatory drugs.

Unlike most of the other medicines in this category, which include over-the-counter analgesics like aspirin, ibuprofen (Advil, Motrin IB, etc.) and naproxen (Aleve) as well as prescription arthritis pills (Lodine, Naprosyn, Relafen, etc), Toradol is used for the short-term relief of pain from trauma or surgery.

It should not be used over weeks or months for arthritis relief, nor is it appropriate for pre-operative treatment or pain relief during labor and delivery.

It is available both as an intramuscular injection for hospital use and as a pill.

According to the manufacturer, it is as effective as some commonly prescribed narcotic pain relievers. It does not have narcotic activity.

Side Effects and Interactions

Among the most common side effects of Toradol are those affecting the digestive tract. They include stomach pain, nausea, indigestion, diarrhea and mouth irritation.

Some people may develop ulcers and intestinal bleeding, particularly if Toradol is taken for a longer
period. Occasionally these problems can occur without obvious symptoms and lead to a life-threatening crisis due to perforation of the stomach lining.

Older people appear to be more susceptible to this problem and should be monitored carefully. Warning signs include weight loss, persistent indigestion, a feeling of fullness after moderate meals, dark or tarry stools, anemia and unusual fatigue. Home stool tests such as Hemoccult or Fleet Detecatest may provide an early indication of bleeding.

Other side effects to be alert for include headache, fluid retention, high blood pressure, rash, itching, gas, constipation, and dizziness.

Do not drive or operate dangerous equipment if you become impaired by insomnia, vertigo, fainting or euphoria.

Less common adverse reactions include flushing, palpitations, changes in appetite, difficulty breathing, and flank pain related to kidney problems. Report any symptoms to your physician promptly.

Toradol can affect both the kidney and liver, so the doctor should monitor their function while you take this medicine.

This medication may interact with other drugs, including aspirin. A person taking a blood thinner like Coumadin or being given heparin may become more vulnerable to a dangerous bleeding ulcer and should be closely monitored on this combination.

LasixBenemid and certain muscle relaxants used in surgery interact with Toradol.

Most NSAIDs can make methotrexate (Folex, Mexate, Rheumatrex), lithium (Eskalith, Lithobid, etc.) and Lanoxin far more toxic. It is not known if Toradol also interacts with these drugs or with Sandimmune.

Check with your pharmacist and physician to make sure Toradol is safe in combination with any other drugs you take.

Special Precautions

People who have had an allergic reaction to Toradol and those who are allergic to aspirin or other anti-inflammatory agents should not take this drug.

Signs of allergy include breathing difficulties, rash, fever, or a sudden drop in blood pressure and require immediate medical attention.

Older people may be more vulnerable to Toradol side effects and may require a lower dose.

Taking the Medicine

Toradol injections are given either on a regular schedule or an “as needed” (prn) basis.

Toradol tablets are given once every four to six hours as needed on a short term basis. Because Toradol can be hard on the digestive tract, it may be taken with food or an antacid.

A high-fat meal may delay absorption and reduce the peak concentration slightly, with no effect on the overall absorption of this medicine.

Taking Toradol with food does not guarantee that the drug will be safe for the stomach.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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