From the Guidelines
Toradol (ketorolac) injections should not be the first-line treatment for migraine relief in adolescents, but may be considered for severe migraines unresponsive to other treatments, with careful consideration of potential side effects and risks. The most recent and highest quality study, 1, published in 2020 in JAMA Neurology, provides recommendations for pharmacologic acute and preventive treatment for migraine in children and adolescents. According to this study, ibuprofen is recommended as the first-line treatment for pain in children and adolescents, while sumatriptan/naproxen oral, zolmitriptan nasal, sumatriptan nasal, rizatriptan ODT, or almotriptan oral may be considered for adolescents. Key points to consider when using Toradol for migraine relief in adolescents include:
- Typical dose: 15-30 mg given as a single intramuscular or intravenous injection, with the lower dose preferred for smaller teens
- Short-term treatment only (less than 5 days) due to potential side effects
- Common side effects: stomach irritation, nausea, and dizziness
- Risks of serious gastrointestinal, kidney, and cardiovascular complications, especially with prolonged use
- Contraindications: kidney problems, bleeding disorders, stomach ulcers, or certain heart conditions
- Monitoring for side effects and administration under direct medical supervision is crucial. Another study, 1, published in 2021 in Nature Reviews Neurology, also highlights the importance of considering other treatment options before using Toradol, and emphasizes the need for careful monitoring and administration under medical supervision. Overall, while Toradol may be effective for migraine relief in adolescents, it should be used with caution and only after careful consideration of the potential risks and benefits.
From the Research
Efficacy of Ketorolac (Toradol) Injection for Migraine Relief in Adolescents
- The provided studies do not directly address the efficacy of ketorolac (Toradol) injection for migraine relief in adolescents 2, 3, 4, 5, 6.
- However, one study mentions that meperidine was arguably equivalent when compared with ketorolac and dihydroergotamine (DHE) but was inferior to chlorpromazine and equivalent to the other dopamine antagonists 4.
- Another study discusses the combination of triptans and nonsteroidal anti-inflammatory drugs (NSAIDs), such as sumatriptan and naproxen, which has demonstrated better efficacy for the acute treatment of migraine 6.
- Ketorolac is an NSAID, but its specific use and efficacy in adolescents for migraine relief is not addressed in the provided studies.
- More research is needed to determine the efficacy of ketorolac injection for migraine relief in adolescents, as the current evidence is limited and indirect 2, 3, 4, 5, 6.