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Toradol: What is it? Uses, Costs, Benefits, and Doses

If you’re familiar with Toradol, it may be because of the widespread use of the drug to treat players in the National Football League, or NFL. In 2011, a dozen retired players who played in the league during the late 1990s and early 2000s made headlines when they sued the league for administering the drug without making players aware of potential side effects and risks. Today, Toradol is a popular option for short-term pain management because it provides additional strength and effectiveness over drugstore medications like Aleve, aspirin, and Advil, but is not an opioid (a class of medications known for its alarming rate of addictions). Although Toradol is associated with serious side effects, its effectiveness and the fact that it is non-habit forming compel doctors to use the drug to treat short-term pain. There’s a lot to know about Toradol, including its benefits, risks, uses, and costs, before asking your doctor about the medication.

What is Toradol?

Toradol is a non-steroidal anti-inflammatory drug (NSAID) that is categorized with medicines like aspirin, ibuprofen, and naproxen. All NSAIDs work to decrease levels of prostaglandins, which are substances in your body that cause inflammation, and they are commonly used to decrease swelling, inflammation, fever, and pain. Unlike medications like aspirin, ibuprofen, and naproxen, Toradol is a prescription drug and is not available without a prescription due to its strength and potential for serious side effects. Toradol is available in an injectable solution, a tablet, and as a nasal spray. The medication is available in a generic form called ketorolac, and it is generally used only for short periods of time (less than five days). Toradol is not a narcotic, opiate, or controlled substance, so it offers a non-habit forming alternative to treat pain so severe that it would otherwise require treatment with opiates or narcotics. 

What is Toradol used to treat?

Toradol is used to treat moderate to severe pain, and it is extremely effective in doing so. The medication generally starts working to relieve pain in about 15 minutes, and relief can last for up to six hours. Toradol is sometimes used to treat pain following surgery and acute migraines, although it can also be used as treatment for chronic migraines that do not respond to other medications. Generally, Toradol is administered in its injectable form and is injected intramuscularly, particularly in the glutes, but the medication is also available as a tablet. People using Toradol to treat post-surgery eye pain or stinging will use the eye drop form of the medication. Toradol is also available as a nasal spray. Toradol is not used to treat mild pain or chronic conditions, such as arthritis, because of the increased potential for side effects in long-term use. 

How does Toradol treat pain?

As an NSAID, Toradol works to treat pain by decreasing inflammation. NSAIDS work by reducing the production of prostaglandins, which are substances in the body that cause inflammation, pain, and fever. Prostaglandins aren’t all bad; they also protect the stomach lining and intestines from stomach acid, aid in blood clotting by activating blood platelets, and help the kidneys function normally. Two types of enzymes produce prostaglandins: COX-1 and COX-2. Although both enzymes create prostaglandins that produce inflammation, pain, and fever, only COX-1 produces the beneficial prostaglandins that protect the stomach and intestinal lining and promote blood clotting. NSAIDs reduce inflammation by blocking the COX enzymes and reducing production of the prostaglandins, which can lead to stomach and intestinal ulcers when used too frequently because the protective qualities of prostaglandins are also diminished. Because Toradol is such a highly powerful drug and works on both COX-1 and COX-2 enzymes, it can cause ulcers much more quickly and more frequently than other NSAIDs.

How much does Toradol cost?

Toradol is available in an injectable solution, an oral tablet, an intramuscular solution, a nasal spray, and eye drops. The generic form of the medication, ketorolac, is covered by nearly all commercial and Medicare drug insurance plans, and pharmacy discount cards can offer savings as well. Manufacturers coupons and patient assistance programs may be available for the brand name version of the drug through the manufacturer’s website. Because a variety of manufacturers produce Toradol’s formula in both brand name and generic forms and the medication is mostly frequently used as a generic, the prices for ketorolac are provided below.

Approximate Costs of Ketorolac (generic Toradol)

 

Per Unit

10 Units

15 mg/mL injectable solution

$1.92

$19.16

30 mg/mL injectable solution

$2.55

$25.46

60 mg/2 mL intramuscular solution

$1.31

$26.30

10 mg oral tablet

$1.76

$17.61

What are the benefits of using Toradol?

Toradol is an extremely effective, non-habit forming alternative to opioids and narcotics for individuals with moderate to severe pain. People with histories of addiction can safely use Toradol to manage their pain after surgery without worry of a relapse. Because Toradol is not a controlled substance, it is also generally easier to obtain. Toradol works well to control pain, including pain associated with migraine headaches that are not controlled by other medication. Because it is available in a variety of forms from a number of manufacturers, Toradol is also affordable and covered by most insurance plans. The medication comes in many different forms, allowing doctors to help patients treat their pain most efficiently. 

How do I know which dose of Toradol I should take?

Your dose of Toradol will depend on your medical condition, your medical history, and the form of Toradol you are using. When taken by mouth, Toradol is generally taken every four to six hours with a full glass of water, and dosage is not to exceed 40 mg in a 12 hour period. Due to the risk of side effects associated with Toradol, you should take the lowest dose possible to control your pain. Your doctor’s orders should be followed exactly in order to minimize the potential for dangerous side effects or allergic reactions. 

How do I use Toradol to treat pain?

Toradol may be used for up to five days to treat pain. When used for periods longer than five days, the risk of side effects, especially stomach bleeding, associated with Toradol increase significantly. Toradol is generally taken every four to six hours to control pain, with no more than 40 mg being consumed in a 24 hour period. However, the medication should be taken at the lowest possible dose to avoid side effects, so it should be taken at the minimum level needed to manage pain. Toradol should be taken with a full glass of water, but it can be taken with or without food. If your stomach becomes upset when taking Toradol, you can take it with food, milk, or an antacid to limit the discomfort. 
 
Although Toradol should be taken at the minimum level required to manage pain, pain medications work most effectively when they are used at the first signs of pain. When taking the medication on an “as needed” basis, take Toradol as your pain begins to set in. The medication may not work as well once pain has intensified, which could lead to an attempt to increase your dose beyond the level that is safe. 

Are there any side effects I should be aware of?

Toradol is extremely effective at controlling moderate to severe pain without the risk associated with opioids and other habit-forming drugs, but there is a substantial risk of side effects associated with Toradol. While many people taking Toradol do not experience serious side effects, side effects become more likely with extended use or high doses of the medication. Common side effects associated with Toradol include:

  • Upset stomach
  • Nausea
  • Vomiting
  • Constipation
  • Diarrhea
  • Gas
  • Dizziness
  • Drowsiness
  • Increased blood pressure

 
If your side effects are persistent or become worse, talk to your doctor. Blood pressure should be monitored regularly and reported to a healthcare professional if it becomes elevated. Unlikely, but potentially serious side effects associated with Toradol include:

  • Fainting
  • Fast/pounding heartbeat
  • Hearing changes, such as ringing in the ears
  • Mental/mood changes, such as confusion or depression
  • Persistent or severe headache
  • Stomach pain
  • Vision changes, such as blurred vision
  • Symptoms of heart failure, including swelling ankles/feet, unusual tiredness, and unusual/sudden weight gain

 
Rare but serious side effects that should be reported to your doctor immediately include:

  • Easy bruising/bleeding
  • Signs of kidney problems, such as changes in the amount of urine
  • Signs of infection, such as fever, chills, or persistent sore throat
  • Symptoms of meningitis, such as unexplained stiff neck or fever

 
In rare cases, use of Toradol can cause serious and sometimes fatal liver disease. Seek immediate medical attention if you experience symptoms of liver damage, including dark urine, stomach or abdominal pain, persistent nausea or vomiting, and yellowing eyes or skin.

Is Toradol considered safe for pregnant or breastfeeding women?

Toradol is an FDA-designated Class C drug for pregnant women in their first and second trimesters, meaning that it is only recommended for use during pregnancy when the benefit outweighs the risk. Existing data does not show an association between Toradol and birth defects, but there is no controlled data on human pregnancy currently available. Because of the lack of conclusive information regarding Toradol’s effect on unborn children, it is recommended that you talk to your doctor before using the medication. Some studies have indicated a risk to the fetus when Toradol is used in the third trimester, so women in their third trimesters should not take Toradol unless it is needed in a life threatening or very serious situation. The use of Toradol during labor and delivery is not recommended because it may adversely affect fetal circulation and prevent or inhibit contractions.  Toradol does pass through breast milk, and studies women who are breastfeeding have demonstrated harmful effects to the baby.  Nursing mothers should not take Toradol and should speak to their doctors regarding an alternate medication or stop breastfeeding if the medication is needed and no alternatives exist. 

What drug interactions do I need to be aware of?

Because Toradol is a powerful NSAID that carries a high risk of side effects, it should not be used in patients taking any other NSAIDs, including aspirin, due to the combined effects of the medications. Toradol increases the risk of bleeding, especially stomach bleeding, so it should not be taken with other drugs that cause bleeding, including anti-platelet drugs and blood thinners. Other medications known to interact with Toradol include:

  • Aliskiren
  • ACE inhibitors
  • Angiotensin II receptor blockers
  • Lithium
  • Methotrexate
  • Probenecid
  • Corticosteroids
  • Medications affecting the kidneys

Who should not take Toradol?

Prior to prescribing Toradol, your doctor should be aware of your complete medical history including over-the-counter medication you're taking. Individuals with heart failure or kidney disease should not take Toradol. People who have a history of asthma, bleeding or clotting problems, blood disorders, heart disease, heart attack, high blood pressure, liver disease, heartburn, growths in the nose, health problems such as throat problems, stomach problems, intestinal problems, stroke, or swelling of the ankles, feet, or hands should use caution when taking Toradol and should make sure their doctor understands their medical history for accurate medical advice. Older adults may be more sensitive to the effects of Toradol and are more likely to experience side effects, especially gastrointestinal bleeding and kidney problems. Women in their third trimester of pregnancy or who are breastfeeding should not take Toradol.

How do I know if Toradol is right for me?

If you are dealing with acute moderate to severe pain for a condition that is not chronic, Toradol may help manage your pain. Toradol is an excellent pain management option for people who have a history of addiction and want to avoid the use of opioids and controlled substances, or those who are looking for a non-habit forming pain medication for any number of reasons. Toradol may be useful in managing migraine headaches that do not respond to other forms of treatment. Toradol should not be used for the management of chronic conditions, treatment of minor pain, or for periods of time longer than five days without the approval and monitoring of a doctor.
 

Published March 28th, 2020 by Bridget Reed
Fact Checked by Chris Riley

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