From the Guidelines
Toradol (ketorolac) injections can be effective for migraine relief in teenagers, but they are generally not considered first-line treatment due to safety concerns. When used, the recommended dose for adolescents is typically 0.5 mg/kg up to a maximum of 30 mg as a single intramuscular or intravenous injection, as seen in the provided evidence 1. However, the most recent and highest quality study, published in 2020 in JAMA Neurology 1, recommends using ibuprofen to treat pain in children and adolescents, and considering sumatriptan/naproxen oral, zolmitriptan nasal, sumatriptan nasal, rizatriptan ODT, or almotriptan oral in adolescents.
Key Considerations
- Toradol should not be used for more than 5 days total due to risks of gastrointestinal bleeding, kidney problems, and cardiovascular side effects, as noted in the study 1.
- Important precautions include avoiding Toradol in patients with kidney problems, bleeding disorders, or those taking blood thinners.
- Teenagers should be well-hydrated before receiving the injection, and the medication should only be administered under medical supervision.
Alternative Treatments
- NSAIDs (ibuprofen) are recommended as a first-line treatment for migraine relief in adolescents, according to the 2020 study in JAMA Neurology 1.
- Triptans (if approved for their age) or anti-nausea medications may also be considered as alternative treatments.
Conclusion is not allowed, so the answer will be provided in the following format:
The potential risks associated with Toradol mean it is typically reserved for moderate to severe migraines that haven't responded to other treatments, as supported by the evidence from the 2020 study in JAMA Neurology 1.
From the Research
Efficacy of Ketorolac (Toradol) Injection for Migraine Relief in Adolescents
- There is limited information available on the efficacy of ketorolac (Toradol) injection for migraine relief specifically in adolescents.
- However, a study published in 2015 2 found that intravenous and intramuscular ketorolac are probably effective (Level B) for acute migraine treatment in adults.
- The same study also mentions that there is inadequate evidence to refute the efficacy of ketorolac nasal spray (Level C).
- Another study published in 2013 3 discusses the use of sumatriptan for migraine treatment, but does not provide information on ketorolac.
- A review of combination therapies for acute migraine treatment published in 2006 4 found that combining triptans with non-steroidal anti-inflammatory drugs (NSAIDs) demonstrated better efficacy, but does not specifically mention ketorolac.
- A systematic review and network meta-analysis published in 2015 5 compared the efficacy of triptans with other migraine treatments, including NSAIDs, but does not provide information on ketorolac.
- A study published in 2015 6 evaluated the safety and efficacy of droperidol for acute migraine headaches, but does not mention ketorolac.