From the Research
It is generally safe to administer intramuscular (IM) Decadron (dexamethasone) and IM Toradol (ketorolac) together as a one-time dose for lumbosacral radiculopathy, as long as precautions and contraindications are considered, based on the most recent evidence from 1 and 2. This combination can be effective for acute pain management as Decadron reduces inflammation around the affected nerve roots while Toradol provides non-opioid pain relief. Typical dosing would be 4-10 mg of dexamethasone and 30-60 mg of ketorolac (with 30 mg being more common) administered in separate injection sites. However, there are important considerations before proceeding:
- Toradol is contraindicated in patients with renal impairment, active peptic ulcer disease, recent GI bleeding, or bleeding disorders.
- It should be used cautiously in elderly patients and those on anticoagulants.
- The combination may elevate blood glucose levels temporarily, which is important for diabetic patients to monitor. While this one-time combination is generally acceptable, Toradol should not be used for more than 5 days due to increased risk of GI and renal adverse effects with prolonged use, as noted in 1. If pain persists beyond the initial treatment, alternative pain management strategies should be considered, such as those recommended in 2. Key points to consider when administering IM injections, as discussed in 3, include selection of injection site, use of appropriate equipment, and proper injection technique to ensure effective administration. Overall, the decision to use this combination should be made on a case-by-case basis, taking into account the individual patient's medical history, current health status, and potential risks and benefits, as emphasized in 1 and 2.