From the Guidelines
No, Toradol (ketorolac) should not be given to a 14-week pregnant woman. This medication belongs to the nonsteroidal anti-inflammatory drug (NSAID) class, which can pose risks to the fetus, particularly in the second and third trimesters, although the risks at 14 weeks are less clear 1. According to the American Family Physician, NSAIDs are not known to be teratogenic in humans, but animal models suggest they can block blastocyst implantation, and their use close to term can lead to several maternal and fetal complications 1.
Key considerations for NSAID use in pregnancy include:
- Potential maternal effects such as prolonged gestation and labor, increased peripartum blood loss, and increased anemia
- Potential fetal effects including increased cutaneous and intracranial bleeding, premature closure of ductus arteriosus, pulmonary hypertension, impaired renal function, reduced urine output, and reduced amniotic fluid volume For pregnant women requiring pain management, acetaminophen (Tylenol) is generally considered the safest first-line option for mild to moderate pain, and any use of pain medication during pregnancy should be under direct medical supervision, weighing the potential benefits against the risks 1. If stronger pain management is needed, the provider may consider other options specifically approved for use during pregnancy.
From the FDA Drug Label
Pregnancy Teratogenic Effects Pregnancy Category C Reproduction studies have been performed during organogenesis using daily oral doses of ketorolac tromethamine at 3.6 mg/kg (0. 37 times the human AUC) in rabbits and at 10 mg/kg (1 times the human AUC) in rats. Results of these studies did not reveal evidence of teratogenicity to the fetus. However, animal reproduction studies are not always predictive of human response Nonteratogenic Effects Because of the known effects of non-steroidal anti-inflammatory drugs on the fetal cardiovascular system (closure of ductus arteriosus), use during pregnancy (particularly late pregnancy) should be avoided. There are no adequate and well-controlled studies of ketorolac tromethamine in pregnant women. Ketorolac tromethamine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus
It is not safe to administer Toradol (Ketorolac) to a woman at 14 weeks gestation without careful consideration of the potential risks.
- The FDA label recommends that use during pregnancy should be avoided, particularly in late pregnancy, due to the potential effects on the fetal cardiovascular system.
- The label also states that there are no adequate and well-controlled studies of ketorolac tromethamine in pregnant women.
- Ketorolac tromethamine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus 2
From the Research
Safety of Toradol (Ketorolac) in Pregnancy
- The use of Toradol (Ketorolac) in pregnancy is a concern due to its classification as a nonsteroidal anti-inflammatory drug (NSAID) [ 3 ].
- According to a study published in 1991, Ketorolac should not be used for obstetric analgesia [ 3 ].
- Another study published in 2019 discusses the safety of over-the-counter medications in pregnancy, but does not specifically address the use of Toradol (Ketorolac) [ 4 ].
- A study published in 2001 discusses the risks and benefits of NSAIDs in children, but does not provide information on the use of Toradol (Ketorolac) in pregnant women [ 5 ].
- The US Food and Drug Administration has a role in approving drugs for marketing, including those for use in pregnant women, but there is limited information available on the safety of Toradol (Ketorolac) in pregnancy [ 6 ].
Key Findings
- Toradol (Ketorolac) is not recommended for use in obstetric analgesia [ 3 ].
- There is limited information available on the safety of Toradol (Ketorolac) in pregnancy [ 4 , 6 ].
- NSAIDs, including Toradol (Ketorolac), have been shown to have analgesic efficacy, but their use in pregnancy is a concern due to potential risks to the fetus [ 7 , 5 ].