When is a Toradol injection appropriate? If an arthritis patient is already on an oral nonsteroidal anti-inflammatory drug (NSAID), is it safe to inject Toradol? How long does pain relief last from an injection of Toradol? Is a Toradol injection ever given in combination with Kenalog? Is Toradol used more for rheumatoid arthritis or osteoarthritis?
Indications for Toradol
Toradol (ketorolac tromethamine) is a nonsteroidal anti-inflammatory drug most often given by injection. It is indicated for short-term management of moderate to severe acute pain. It may be given for up to 5 days in adults.
Risks Associated With Toradol
Toradol is a potent NSAID and is associated with many risks. The risks associated with Toradol include, but are not limited to:
- bleeding including bleeding ulcers
- renal (kidney) impairment
- allergic reactions -- all of which can be life-threatening
According to rheumatologist Scott J. Zashin, MD, "Patients with risks for these problems probably should not receive the drug. It should be avoided in patients already on an oral NSAID (like ibuprofen or Mobic or naproxen) and is not typically given in combination with an injectable corticosteroid."
Dr. Zashin continued, "In fact, there may be an increased risk of bleeding ulcers when corticosteroids and NSAIDS are given simultaneously. The typical dose per injection of Toradol is 60 mg, but should be reduced to 30 mg for patients less than 110 lbs or greater than 64 years of age."
Toradol Is Helpful for Some But Not for Everyone
One indication for this drug is for patients who are unable to tolerate oral medications -- for example, during a post-surgical phase. The drug should not be used for minor or chronic painful conditions. It is only to be used short term for severe pain.
Dr. Zashin is clinical assistant professor at University of Texas Southwestern Medical School and an attending physician at Presbyterian Hospitals of Dallas and Plano. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of TNF Blockers. The book is useful for anyone on one of the biologic drugs or considering the biologic drugs.