Toradol (Ketorolac): Description, Pharmacokinetics, Benefits of Toradol Administration, Indications, Contraindications and Side Effects, Effects on Ability to Drive and Use Machines, Administration during Pregnancy or Breast-Feeding, Storage Requirements
- Toradol Pharmacodynamics
- Benefits of Toradol Administration
- Contraindications to Use
- Usage during Pregnancy and Breast-Feeding
- Effects on Ability to Drive and Use Machines
- Toradol Drug Interactions
- Presentation Forms of Toradol
- Storage Requirements
- Safety Note
- Irregular Use
- Expired Toradol
Toradol is pharmaceutical drug containing ketorolac as active substance. Toradol is nonsteroidal anti-inflammatory drug falling into the group of acetic acid derivatives. It is structurally related to indomethacin. Toradol is a prostaglandins biosynthesis inhibitor. It has also a strong analgesic effect. This medication is included into a list of life-saving and essential medicinal products. Toradol is prescribed for treatment of post-surgery pain, eye inflammation, eye retina disorders, vision loss after cataract surgery, photophobia and other conditions.
The main pharmacological characteristics:
Being non-steroidal anti-inflammatory agent, Toradol is a derivative of pyrrolizine-carboxylic acid. It takes a pronounced analgesic effect, has anti-inflammatory and moderate antipyretic impact. Action mechanism is tightly connected with inhibition of cyclooxygenase activity which is the main enzyme of eicosatetraenoic acid metabolism. This acid is a predecessor of prostaglandins which play the key role in pathophysiologic mechanisms of inflammation, pain and fever.
When taken perorally, Toradol gets absorbed in gastro-intestinal tract. Cmax in blood plasma is achieved in 40-50 minutes either after peroral intake or after intramuscular injection. Food acceptance doesn’t influence the absorption of the medication. Plasma protein binding makes more than 90%.
Elimination half-life is 4-6 hours either after peroral intake or after intramuscular injection. More than 90% of the dosage is cleared with urine: 60% – in unchanged form, the rest is cleared via intestinal canal. Patients suffering from renal failures and elderly people have the decreased rate of clearance; half-life increases.
Benefits of Toradol Administration
Toradol is used for treatment, control, prevention and improvement of the following diseases, conditions and symptoms:
- Post-surgical pain;
- Eye inflammation;
- Eye retina disorder;
- Eye retina issue connected with cataract extraction;
- Loss of vision after cataract surgery;
- Pain and photophobia of patients tolerated an eye operation.
Long-term arresting of moderate and severe acute pains requiring anesthetization of intensity analogical to the opiate one, such as injuries, toothache, pains during post-natal and post-surgery period, oncological diseases, myalgia, arthralgia, neuroglia, radiculitis, closed dislocations, sprains, rheumatic disorders.
Contraindications to Use
Toradol has the following counter-indications:
- Hypersensitivity to non-steroidal anti-inflammatory agents including aspirin (aspirin triad: combination of bronchial asthma, recurrent nasal polyposis and accessory sinuses of the nose, as well as of intolerability to acetylsalicylic acid and pyrazolone group);
- Chronical pain syndrome;
- Nasal polypus;
- Quincke’s edema;
- Bronchial spasm;
- Bronchial asthma;
- Peptic ulcer;
- Renal function impairment;
- Hepatic failure;
- Hypovolaemia (regardless of its cause);
- High risk for postoperative hemorrhage development or incomplete bleeding blockage;
- Impaired haemopoiesis;
- Erosive-ulcer affections of gastro-intestinal tract in the exacerbation phase;
- Intracerebral hemorrhage;
- Hypocoagulation (including hemophilia);
- Lactation (within the treatment course, breast feeding should be terminated);
- Under age (under 2 years of age).
Toradol is to be taken with reserve in the following cases:
- Tobacco smoking;
- Elderly age (above 65);
- Post-surgical period;
- Active hepatitis.
Posology and Administration
The dosage is selected individually according to severity of pain syndrome. A one-time dosage is 10-30mg, frequency of administration is up to four times per day (each 6-8 hours). Maximal daily dose for adults is not more than 120mg (for injections) and 40mg (for tablets). Maximal daily dosage for elderly patients is 60mg. Solution in ampules is prescribed intramuscularly or intravenously for arresting of acute and severe pain during not more than five days, among children – two days. Tablets are assigned for not more than seven days. Toradol is taken by children only in the form of injections.
Usage during Pregnancy and Breast-Feeding
Toradol is counter-indicative during pregnancy, aborning and lactation period (breast-feeding). The drug is counter-indicative in the capacity of premedication remedy, supporting anesthesia, and for pain management in obstetric practice, since it may influence the increase the duration of pre-labor phase. Moreover, Toradol may inhibit the contractility of uterus and fetal circulation.
Effects on Ability to Drive and Use Machines
If within the Toradol therapy course drowsiness, vertigo, insomnia or depressions occur, a patient should be particularly careful while fulfilling potentially dangerous operations requiring heightened level of awareness and quickness of psychomotor abilities.
Toradol Drug Interactions
- In case of simultaneous intake of Toradol with other non-steroidal anti-inflammatory agents, development of additive side-effects is possible;
- Co-administration with pentoxifylline and anticoagulants (including heparin in small dosage) may cause the increased risk of bleeding;
- Simultaneous intake with ACE inhibitors may result in increase of hepatic function disorder;
- Co-administration of Toradol with probenecid may lead to increase of ketorolac concentration in blood plasma during its elimination half-life;
- Combination of Toradol along with lithium medications may decrease renal clearance of lithium and increase its concentration in blood plasma;
- Simultaneous intake with furosemide may cause the reduction of its diuretic action.
- Ketorolac administration decreases demand in usage of opioids for the purpose of anesthetization.
Presentation Forms of Toradol
Toradol is issued in the following presentation forms:
- Solution for injection 30mg/ml in ampules;
- Tableted form in coating containing ketorolac tromethamine in the dosage of 10mg.
The list of analogues with similar active substance runs as follows: Adolor, Akyular LS, Dolac, Dolomine, Ketanov, Ketalginem, Ketokam, Ketolac, Ketorol, Ketorolac, Ketorolac Rompharm, Ketorolac-OBL, Ketorolac-Escom, Ketorolac tromethamine, Ketorolac tromethamine-Pharmaplant; Ketophril, Torolac.
Do not store above 15–30 °C. Keep out of reach of sunlight. Keep out of reach of children and animals. Expiry date is three years. Do not flush Toradol in toilet or drainage systems, since it will harm the environment.
Patients suffering from impairments of hepatic and renal functions, chronic cardiac failure, arterial hypertension and patients who have erosive ulcer gastro-intestinal disorders and gastro-intestinal bleeding in the past medical history should take Toradol with care. Toradol should be administered carefully in post-surgery case when a patient needs a thorough hemostasis (after prostatic gland resection, tonsillectomy and in cosmetic surgery), as well as by patients of elderly age, since the elimination half-life of Toradol prolongs, and plasmatic clearance may decrease. This category of patients should take this medication in dosage close to the lower limit of therapeutic guidelines. In case of hepatic failure symptoms, skin rash, eosinophilia, Toradol intake must be terminated. Toradol is counter-indicative to patients suffering from chronic pain syndrome.
In case you have missed the nest intake of Toradol, use it as soon as possible. If the time of the nest intake is close, you may miss the preceding intake and continue observing the normal schedule of the medicines intake. Do not take the additional dose of Toradol in order to compensate the missed intake. If you come across this problem regularly, think of the possibility of reminders setting or ask your family members to follow your schedule. You should consult your attending therapist for correction of schedule in order to compensate the missed intake of Toradol (if you missed a considerable number of days).
- From the part if cardio-vascular system: seldom – brachycardia, arterial blood pressure changes, arrhythmia, fainting.
- From the part of alimentary system: nausea, stomachache, diarrhea are possible; seldom – uncleared bowels, flatulency, feeling of overfilling of gastro-intestinal tract, hepatic function disorder.
- From the part of central nervous and peripheric system: anxiety, headache, drowsiness are possible; seldom – paresthesia, depression, euphoria, sleep disorders, vertigo, distortion of the sense of taste, distortion of the sense of taste, motor disturbance.
- From the part of respiratory system: seldom – irregular breathing, asthma attack.
- From the part of urinary system: seldom – frequent urination, oligohydruria, polyuria, proteinuria, hematuria, azotemia, acute renal failure.
- From the part of coagulation system: seldom – nasal bleeding, anemia, eosinophilia, thrombocytopenia, bleeding from post-surgical injuries.
- From the part of metabolic activity: possible enhancement of diaphoresis, edema; seldom – oliguria, level increase of creatinine and/or BUN in blood plasma, hypoglycemia, hyponatremia.
- Allergic reactions: rashes, hemorrhagic rash are possible; very seldom – exfoliative dermatitis, urticarial fever, Lyell’s syndrome, Stevens Johnson’s syndrome, acute serum sickness, bronchial spasm, Quincke’s disease, myodynia.
Other reactions: fever is possible.
Local effects: pain in location of injection.
Do not surpass the recommended dose. Excessive usage of medication will not alleviate your condition, but may cause serious intoxication and severe adverse effects. In case you experienced side-effects from Toradol intake, you should seek immediate medical attendance. You are required to take the package, container or name of the drug in order to make diagnosis establishing easier. Do not give your medications to other people even in case they experience the same condition or you think you have a number of similar symptoms, since it may lead to overdose. Consult your attending doctor or pharmacist and examine the information on the package.
Even one intake of Toradol with expired period may result in serious consequences. You should consult your attending doctor if you feel weakness or sickliness. Besides, expired Toradol may lose its efficiency in struggle against your disease. In order to ensure your own safety, you should refuse the intake of expired medications. If a patient suffers from disorders requiring the constant intake of medicines (life-threating cardiac diseases, convulsions, allergic reactions), he should adjust a reliable channel with supplier of his medication in order to have a stock of fresh medication with normal expiry date.
Frequent Questions about Toradol Generic at My Canadian Pharmacy
Can I control heavy industrial equipment during Toradol intake?
In case you feel drowsiness, vertigo, hypotension after Toradol intake, you have to refuse driving and control of heavy industrial equipment. Medical experts recommend refusing alcohol taken along with Toradol, since ethanol enhances side-effects and drowsiness considerably. A patient needs to consult a physician in order to get consultation with due attention to individual characteristics of organism and overall health condition.
Does Toradol cause addiction or dependence?
Toradol doesn’t build up a tolerance. A patient should examine the information on the package in order to make sure Toradol doesn’t belong to the group of the controlled ones. Besides, it is not recommended self-medicating. Do not habituate your organism to medicaments without consultation by a specialist.
Is it possible to stop taking Toradol momentarily or it should be refused gradually by reducing the dosage?
Some patients are not allowed to terminate medicine’s administration abruptly due to constitutional peculiarities, overall health condition and other medicinal products intake. A patient should consult his attending doctor to clarify this matter.