Toradol- A short term treatment for mild to severe pain

Toradol is a NSAID that treats inflammation in our body. It works by reducing the pain causing hormones in our body. It is also used as short term treatment (minimum five days or less) to manage moderate to severe pain. The generic name of this medication is Ketorolac and brand name is Toradol.

Important information

Avoid using Toradol if you have any recent or active bleeding (including internal bleeding in your body), a stomach ulcer, and serious kidney disease, head injury, blood-clotting disorder, a bleeding, history of serious allergy to an NSAID or aspirin, if any surgery is scheduled, if you are in last couple of months of pregnancy or if you are nursing a baby.

Also avoid using Toradol if you are taking pentoxyflyine, aspirin, probenecid or any other NSAID. Toradol can lead to risks like heart stroke, heart attack when used for a prolonged period or in high doses or if you are suffering from heart disease. Avoid using this medicine prior and post heart bypass surgery. Toradol can lead to intestinal or stomach bleeding, which can be life threatening. These conditions can arise while you are on Toradol, especially in elderly people. Do not take this medicine if you have bleeding intestines or stomach.

Avoid drinking alcohol while using Toradol. Alcohol can accelerate stomach bleeding that occurs due to ketorolac.

To make sure whether Toradol is safe for you or not, speak to your doctor if you have

  • liver disease
  • high BP, high cholesterol, heart disease, diabetes or if you smoke
  • asthma
  • kidney disease
  • fluid retention
  • history of bleeding or stomach ulcers
  • Ulcerative colitis, Crohn’s disease or inflammatory bowel disease

Avoid using Toradol if you are allergic to ketorolac of have

  • recent or active stomach ulcer, intestinal bleeding, stomach bleeding
  • if any of your surgery is due like bypass surgery
  • dehydration or serious kidney disease
  • blood clotting disorder or bleeding disorder
  • bleeding in the brain or a head injury
  • bleeding due to a recent surgery
  • history of allergic reaction using any NSAID or aspirin or asthma
  • If you are in last trimester of your pregnancy or nursing a baby

How to use Toradol?

Toradol is initially given in the form of injection and later used as an oral medicine. The injection is given into a vein or a muscle through an IV. Your doctor can give you the injection.

Follow the instructions as given on the label. Do not use the medicine in high doses or for a prolonged period. Use the lowest dose that can be effective to treat your medical condition.

Avoid using Toradol for more than 5 days, including tablets and injection. Using the medication for a long term can cause bleeding or damage your kidneys.

Make sure you consult your doctor before using Toradol to know how to use the drug safely and what is the lowest effective dose for you. It will help you get maximum benefits.

 

 

Find out if using Toradol is safe during pregnancy or breastfeeding

Women come up with a lot of question regarding use of NSAIDs during their pregnancy or breastfeeding. This article will help you know if using Toradol is safe during pregnancy and breastfeeding.

Toradol and Pregnancy

Studies have not been conducted on Toradol during pregnancy in humans. However, some studies conducted in past on animals suggest that Toradol use can harm the foetus. Toradol can lead to complications in labour and delivery if used during pregnancy. Therefore many doctors do not recommend Toradol during pregnancy especially during the third trimester.

Since use of Toradol can have harmful effects on foetus and also can lead to complications in delivery and labour, doctors do not prescribe Toradol during pregnancy. FDA has given C category to classify Toradol. Also the medicines that are not yet studied in animals or pregnant women are given category C by FDA. If your doctor thinks that the benefits are more than the risks associated to the unborn child, he might recommend the use of Toradol during pregnancy.

If you are planning your pregnancy or you are pregnant, while you are on Toradol, let your doctor know that you are pregnant. Your doctor will help you take the right decision.

Toradol and Breastfeeding

In the past Toradol wasn’t recommended for breastfeeding mothers. It also had a black box warning to say that it is not safe for breastfeeding mothers to use Toradol. As per recent studies it has been discovered that Toradol secrets in breast milk in quite low amounts, may be too low to lead to any problems in many cases. Make sure that while breastfeeding; discuss with your doctor whether you can use Toradol.

In some cases women who undergo C-section find it necessary to use Toradol post child birth. In such cases to manage pain in such patients, Toradol is preferred as they can help the patient to get control over pain, but yes it can also result in possible side effects.

If you are using Toradol with your doctor’s prescription make sure you keep a check on your baby’s health and contact your paediatrician in case you notice any unusual symptoms.  FDA has not approved the use of Toradol in breastfeeding mothers, though American academy of paediatrics have discovered that Toradol is safe while breastfeeding.

Nursing mothers can also look out for other options to get relief from pain so that they don’t have to depend on Toradol. They can check with their doctor for alternative pain relief medications or therapy which can help them get rid of pain without affecting their baby’s health. This will help them continue with breastfeeding while they are on any other medication. If you think you can manage your pain without Toradol and using other medications, try for alternative medicines.

Some women who undergo severe pain find it essential to use Toradol, in such cases they decide to discontinue breastfeeding to avoid any harm to their baby. This helps them fight pain and take care of their baby.

 

Consider the lowest effective dose of Toradol for maximum benefits

While using Toradol consider the risks and benefits of Toradol and other alternative treatment options before you decide to take Toradol. Use the lowest effective dose for short term that goes with the treatment goals of each individual. In adults, the duration of both IM and IV dosing of ketorolac tromethamine and Toradol should not be exceeded for more than 5 days.

Change from IM or IV dosing of ketorolac tromethamine (single/multiple dose) to multiple dose Toradol.

Patients in age group of 17-64 yrs

20mg PO given once followed by q4-10mg – 6 hours prn not more than 40 mg per day

Patients with age 65 or above, renally impaired having weight less than 50kg : 10mg PO given once followed by q4-10mg – 6 hours prn not more than 40 mg per day

Note

Avoid giving oral formulation as an initial dose

Minimum effective dose should be used for each patient

Do not reduce the dosing interval of 4-6 hours

Total treatment duration in adult patients:

The duration of use of both IM and IV dosing of ketorolac tromethamine and Toradol not exceeding 5 days

Dosing instructions

Age less than 17 years – oral not approved

Adult age 17-64 years

20 mg once, then 10mg q4- 6 hours prn not more than 40 mg per day

What if I miss a dose?

As Toradol is a pain medication, there are fewer chances that you miss a dose, but in case you miss a dose, skip the missed dose in case it is almost the time for your next dose. Avoid taking extra medicine to make up for the missed dose.

What if I overdose?

Seek help from poison control centre or your health care provider.

Toradol Overdose and treatment

Signs and symptoms of overdose

Symptoms related to overdose of NSAIDs are normally limited to nausea, vomiting, drowsiness, epigastric pain and lethargy, which can be treated with timely supportive care. Gastrointestinal bleeding can also occur. Respiratory depression, coma and acute renal failure are some rare symptoms. Anaphylactoid reactions have been observed with the use of NSAIDs and it can also lead to overdose

Treatment

Patients should be treated with supportive care and symptomatic care for a Toradol overdose. There are no particular antidotes available. Activated charcoal (60-100g in adults, 1g/kg – 2g/kg in children) or osmotic cathartic can be indicated in patients observed within 4 hours of drug ingestion with symptoms or in patients who overdose by taking large doses like 5-10 times than the normal dose.  Urine alkalization, hemoperfusion, hemodialysis or forced dieresis might not be helpful in some cases.

Single overdose of this medication is linked to nausea, abdominal pain, hyperventilation, vomiting, peptic ulcers, renal dysfunction, and erosive gastritis after stopping the dosage.

In case of overdose, medical help should be given to the patient as soon as possible so that the toxicity can be removed from patient’s body and the life threatening risks can be reversed. The effectiveness of treatment depends on the duration of drug ingestion and the amount of drug taken.

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