Generic Toradol (Ketorolac)
Toradol (Ketorolac) is widely known as a non-steroidal anti-inflammatory agent from the group of acetic acid derivatives, structurally related to indomethacin. Ketorolac acts by reducing hormones that produce swelling and pain in different body regions.
Toradol is a short-term medication (used for five days or less) to cure moderate to severe pain. Toradol (Ketorolac) can be taken orally, intramuscularly and intravenously.
After oral administration, it is absorbed from the gastrointestinal tract. Cmax in plasma is reached in 40-50 minutes both after oral administration and after i/m intake. Food intake does not have an impact on absorption. Plasma protein binding is more than 99%. T1/2 — 4-6 hours both after oral ingestion and after i/m administration.
About 90% of the active ingredient is excreted renally, 60% in unchanged form; the rest is excreted through the bowels.
In patients having decreased kidney function and senior patients, the elimination rate decreases, T1/2 increases.
Store the drug in the dark place, at a temperature of 15-30 C.
Hypersensitiveness (including to aspirin and other NSAIDs), chronic pain syndrome, nasal polyps, angioedema, bronchial asthma, complete or partial nasal polypus syndrome, bronchial spasm, giant urticaria, history of the stomach, duodenal ulcer, and duodenal cyst, hypovolemia, dehydration, high risk of postoperative bleeding or incomplete hemostasis, hematopoietic disorders, hemorrhages in the brain, children (up to 2 years).
Contraindicated in pregnancy, during childbirth and during lactation (breastfeeding).
Ketorolac is counter-indicative for use as a means for sedation, supporting anesthesia and for anesthesia in obstetric practice, since under its influence may prolong the time-length of the first period of labor. In addition, Ketorolac can inhibit uterine contractility and fetal blood circulation.
Patients with chronic heart failure, arterial hypertension, erosive and ulcerative lesions of the gastrointestinal tract and bleeding from the gastrointestinal tract in past medical history should take the medication in question with care.
The drug should also be taken with caution in the postsurgical period in cases when particularly careful hemostasis is required (including after resection of the prostate gland, tonsillectomy, in cosmetic surgery), as well as in elderly patients, since the half-life of ketorolac is lengthened, and plasma clearance may be reduced. In this category of patients, it is recommended to take the drug in doses close to the lower limit of the therapeutic range. If symptoms of liver damage, skin rash, high eosinophil count, Ketorolac should be canceled. Ketorolac is not good for use in the chronic pain syndrome.
If drowsiness, dizziness, insomnia, or depression appear during the period of cure with Ketorolac, special caution should be exercised during occupations of potentially hazardous activities requiring increased attention and psychomotor speed.
- 1 film-coated tablet contains Ketorolac tromethamine 10 mg; in the blister of 10 pieces, in a box of 1 or 2 blisters.
- 1 ampoule with 1 ml of injection solution — 30 mg; in a blister pack of 5, in a box of 1 blister.
Length of treatment with Ketorolac should not be more than 7 days, prolonged intake, as well as ingestion of a dose of more than 40 mg per day, is not recommended. To reduce the risk of side effects, it is advised to use the minimum effective dose for the minimum time required to relieve pain.
How to take Toradol?
The dosage is chosen individually, taking into account the severity of pain. A single dose is 10-30 mg, the frequency of administration — up to 4 times a day (every 6-8 hours). The maximum daily intake for adults is no more than 120 mg for injection (60 mg for elderly patients, patients with renal insufficiency, patients whose weight is less than 50 kg) and 40 mg for tablets (10 mg every 4 or 6 hours as required).
A solution in ampoules is prescribed i/m or i/v for the relief of acute and severe pain for up to 5 days, for children — 2 days. Tablets are prescribed for no more than 7 days. In children, Toradol is used only in injections.
The recommended daily intake during the transfer of parenteral intake of the drug to the ingestion is 90 mg (part of the dose administered orally with a combined administration should not be more than 40 mg per day changes in the form of administration).
Elderly people: it is advised to lengthen the intervals between taking the drug, ie, 6-8 hours. Patients over 65 are advised to take the amount of the drug corresponding to the lower therapeutic limit.
Dyspepsia, gastrointestinal pain, nausea, vomiting, diarrhea, peptic ulcers, abnormal liver function, gastrointestinal bleeding, stomatitis, headache, dizziness, drowsiness, sweating, swelling, pain at the injection site, flatulence, gastritis, constipation, dyspnea, bronchial asthma, urticaria, pruritus, rash, anaphylactic reactions, asthenia, purpura, myalgia, vasodilation, pallor, dry mouth, nervousness, depression, increased urination, oliguria, glomerulonephritis, nephrotic syndrome, acute renal failure, etc.
An overjolt of Ketorolac with a single or repeated use is normally manifested by abdominal discomfort, the occurrence of peptic gastric ulcers or erosive gastritis, renal dysfunction, hyperventilation, metabolic acidosis. The mentioned symptoms are cured after stopping the drug. In these cases, gastric lavage, the introduction of adsorbents (activated carbon) and symptomatic therapy are recommended. Ketorolac is not sufficiently eliminated by dialysis.
The medicine in question is incompatible with lithium preparations, pentoxifylline, probenecid, anticoagulants (including low-dose heparin), since it may increase the risk of bleeding. Reduces the diuretic effect of furosemide in persons with normoxia. When combined with furosemide, its diuretic effect may be reduced by approximately 20%. With simultaneous use with ACE inhibitors increases the likelihood of impaired renal function.
A possible interaction of ketorolac and non-depolarizing muscle relaxants, leading to the development of apnea, is noted.
Additive adverse events may sometimes develop: with probenecid — ketorolac concentration in plasma and its half-life increase is possible.
The need for the use of opioid analgesics for pain relief is reduced with Ketorolac.
Rare cases of the development of convulsive seizures in combination with Ketorolac and anticonvulsant drugs (phenytoin, carbamazepine) have been described.
There may be hallucinations against the background of simultaneous ingestion of Ketorolac and psychologic drugs (fluoxetine, thiothixene, alprazolam).
Toradol and alcohol interaction
Ketorolac has an inhibitory effect on the central nervous system, blocking the transmission of impulses along the nerve fibers. Tablets act quickly, shots — even faster. Ketorolac has an analgesic effect on the similar principle as alcohol, but when combined with alcohol, the effectiveness of the drug decreases. The drug doesn’t have an anti-inflammation and antipyretic impact and is used only for pain relief. Due to the strong and fast analgesic action, many tries to take such pills with or after alcohol. On the one hand, it will quickly help relieve severe headache, hangover symptoms, and acute alcohol intoxication. On the other hand, serious health problems are possible due to medicament incompatibility.
Ketorolac itself has serious adverse effects, primarily from the gastrointestinal tract. The stomach and intestines are extremely negative for non-steroidal anti-inflammatory drugs. Due to the repercussions, such strong and harmful painkillers are usually prescribed in extreme cases: for injuries and fractures, oncology, after dental operations.
Ketorolac and all analog drugs (Ketanov, Ketorol, Ketofril, Akular) are acetic acid derivatives. They have a quick analgesic effect due to the inhibitory effect on the nervous system. Alcohol acts similar, and also increases the negative effects on the gastrointestinal tract.
Consequences of combination with alcohol: depression of the central nervous system, CNS involvement ranging from somnolence and disorientation to personality change, convulsions, paralysis, and death. The progression of inflammatory processes, a strong increase in temperature. NSAIDs do not help. Internal bleeding, severe damage to the stomach and intestines. Reducing the potency and duration of exposure to the drug. Metabolic load on the organs of detoxification (in the first place — liver, kidney).
Michael: Drugs that begin with keto- are considered to be the most powerful pain compliance tools, and as far as I know, they are quite versatile, that is, they help from various pain sensations. Ketorolac is an analog of more expensive Ketonal.
Abigail: Those who suffer from urolithiasis will understand me. When a stone leaves a kidney, the pain is quite strong, many women compare it with childbirth. For me, pain in the kidneys is a usual thing. Exiting a stone can be very painful, but sometimes you can do without pills. According to my observations, I can tell it depends on the size of the stone. During the first exit, they took me to the hospital by ambulance — this was my first time. It’s hard to forget and I don’t want to repeat, but since I have a tendency towards such events, I always have no-shpa and ketorolac in my purse. The other day I felt the familiar symptoms when the pain in a few minutes was quite strong, I realized that I could not do without pills. Immediately 1 tablet of no-shpa and 1 tablet of ketorolac were drunk. The pain stopped in 10-15 minutes. Only occasionally I felt a slight tingling sensation. After the pill, I was drowsy.
Ethan: It is a good drug. One of the most popular for anesthesia. Well, it helps in the postoperative period, for the relief of acute pain. I prescribe myself this drug sometimes. Efficient and relatively inexpensive. Available in convenient forms. It is indicated for many pain syndromes. My wife uses it for menstrual cramps.