From the Guidelines
Yes, Toradol (ketorolac) IM injection can help with a gout flareup, but it is not considered first-line therapy for gout. Toradol is a potent non-steroidal anti-inflammatory drug (NSAID) that can reduce the pain and inflammation associated with acute gout attacks, as supported by high-quality evidence from the American College of Physicians guideline on management of acute and recurrent gout 1. The typical dose is 30-60mg as a single IM injection, with a maximum duration of 5 days of total ketorolac treatment (including any oral follow-up). However, medications like colchicine, oral NSAIDs (like naproxen or indomethacin), or corticosteroids are typically preferred for gout management, as they have been shown to be effective in reducing pain and inflammation in patients with acute gout, with corticosteroids being a strong recommendation for first-line therapy due to their high-quality evidence and low-cost treatment option 1.
Some key points to consider when using Toradol for gout include:
- Avoiding Toradol if you have kidney problems, history of GI bleeding, or are taking blood thinners, as it can increase the risk of adverse effects 1
- Not taking other NSAIDs concurrently with Toradol due to increased risk of side effects, such as gastrointestinal perforations, ulcers, and bleeding 1
- Being aware that Toradol works by inhibiting prostaglandin synthesis, which reduces inflammation, but it doesn't specifically target the underlying cause of gout—uric acid crystal formation 1
- Considering the potential harms of Toradol, including dyspepsia, gastrointestinal perforations, ulcers, and bleeding, as well as the potential benefits of reducing pain and inflammation in patients with acute gout 1
Overall, while Toradol can provide relief for gout flareups, it is essential to weigh the potential benefits and harms and consider alternative treatment options, such as colchicine, oral NSAIDs, or corticosteroids, which have been shown to be effective in managing gout symptoms and are typically preferred as first-line therapy 1.
From the Research
Treatment Options for Gout
- Non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, and corticosteroids are options for the management of acute gout 2, 3, 4, 5
- Toradol (ketorolac) is an NSAID that can be administered intramuscularly (IM) and may be used to help manage pain associated with a gout flareup
- The choice of treatment for acute gout depends on various factors, including comorbidities and patient preference 3, 4, 5
Efficacy of Toradol IM for Gout Flareup
- While there is no direct evidence in the provided studies specifically addressing the use of Toradol IM for gout flareup, NSAIDs are generally considered effective for managing acute gout symptoms 2, 3, 4, 5
- Toradol IM may be considered as an option for managing pain associated with a gout flareup, especially in patients who cannot tolerate oral medications or require rapid pain relief