From the Guidelines
Toradol (ketorolac) injections generally do not significantly affect blood sugar levels in patients with diabetes mellitus. This non-steroidal anti-inflammatory drug (NSAID) works primarily by inhibiting prostaglandin synthesis through blocking cyclooxygenase enzymes, which is different from medications that directly impact glucose metabolism. Unlike corticosteroids, which can cause notable elevations in blood glucose, ketorolac does not have direct hyperglycemic effects. However, patients with diabetes should still monitor their blood glucose levels when starting any new medication, including Toradol, as individual responses can vary. It's also important to note that Toradol has limitations for use - it should not be used for longer than 5 days due to increased risk of gastrointestinal bleeding and kidney complications. Additionally, diabetic patients often have comorbid conditions like kidney disease that may require dose adjustments or contraindicate Toradol use altogether. Always consult with a healthcare provider before using Toradol, especially for patients with diabetes who have renal impairment or other complications 1.
Some key points to consider:
- Toradol's mechanism of action does not directly impact glucose metabolism 1
- Monitoring blood glucose levels is still necessary when starting Toradol, due to individual variability in response 1
- Limitations of use, such as not exceeding 5 days of treatment, are crucial to minimize risks of gastrointestinal and kidney complications 1
- Patients with diabetes and comorbid conditions, like kidney disease, require careful consideration and potential dose adjustments or avoidance of Toradol 1
From the FDA Drug Label
Metabolic and Nutritional: hyperglycemia, hyperkalemia, hyponatremia Yes, Toradol (ketorolac) injection can affect blood sugar levels in a patient with diabetes mellitus (DM), as hyperglycemia is listed as a possible adverse reaction in the drug label 2 and 3.
From the Research
Effect of Toradol on Blood Sugar Levels in DM Patients
- There is no direct evidence from the provided studies that Toradol (ketorolac) injection affects blood sugar levels in patients with diabetes mellitus (DM) 4, 5, 6, 7, 8.
- The studies primarily focus on the analgesic efficacy, pharmacodynamic and pharmacokinetic properties, and therapeutic use of ketorolac in pain management, as well as its potential effects on renal function and gastrointestinal tract 4, 6, 7, 8.
- One study mentions that perindopril, an angiotensin-converting enzyme inhibitor, does not affect glycemic control in diabetic patients, but this is not directly related to the use of Toradol 5.
- Another study notes that ketorolac can cause acute renal failure, which may be reversible, but does not discuss its impact on blood sugar levels 4, 7, 8.
- Overall, there is a lack of research specifically investigating the effect of Toradol on blood sugar levels in DM patients, and therefore, no conclusive evidence can be provided 4, 5, 6, 7, 8.
Renal Function and Toradol
- Toradol can cause acute renal failure, especially in patients with pre-existing renal conditions or those taking high doses for extended periods 4, 7, 8.
- The drug's inhibitory effect on prostaglandin-mediated vasodilation can lead to decreased renal perfusion and ureteral pressure, which may compromise renal reserve 8.
- Patients with compromised renal function should exercise caution when using Toradol, and renal function should be closely monitored 7.
Pain Management and Toradol
- Toradol is a strong analgesic with a tolerability profile similar to other NSAIDs, making it a useful alternative or adjuvant to opioids in patients with moderate to severe pain 6.
- The drug has been shown to provide effective pain relief in various clinical settings, including postoperative pain, renal colic, and cancer pain 6, 8.