From the Guidelines
Ketorolac (Toradol) should be avoided in patients with seizure disorders due to its potential to lower the seizure threshold and interact with antiepileptic medications. The use of ketorolac in patients with seizure disorders is not recommended, as it may increase the risk of seizure activity or make seizures more difficult to control 1. According to the provided evidence, metoclopramide (Reglan) is contraindicated in patients with seizure disorders, and while ketorolac is not explicitly contraindicated, its potential risks in seizure patients cannot be ignored.
Key Considerations
- NSAIDs like ketorolac can lower the seizure threshold in some individuals, potentially triggering seizure activity or making seizures more difficult to control.
- Ketorolac may interact with certain antiepileptic medications, affecting their efficacy or metabolism.
- Safer alternatives for pain management in seizure patients include acetaminophen (Tylenol) as a first-line option.
- If stronger pain relief is needed, consultation with a neurologist about appropriate opioid options that won't interfere with seizure control is recommended.
Pain Management Alternatives
- Acetaminophen (Tylenol) is a safer first-line option for pain management in seizure patients.
- Consultation with a neurologist is necessary to determine the best course of pain management for seizure patients, taking into account potential medication interactions and the need to maintain optimal seizure control.
From the FDA Drug Label
Antiepileptic Drugs Sporadic cases of seizures have been reported during concomitant use of ketorolac tromethamine and antiepileptic drugs (phenytoin, carbamazepine).
The use of Ketorolac (Toradol) in a patient with a seizure disorder may increase the risk of seizures, as sporadic cases have been reported during concomitant use with antiepileptic drugs. Therefore, caution should be exercised when administering ketorolac to patients with a history of seizure disorders. 2 2
From the Research
Effect of Ketorolac on Seizure Disorder
- There is no direct evidence in the provided studies to suggest the effect of Ketorolac (Toradol) on a patient with seizure disorder 3, 4, 5, 6, 7.
- The studies primarily focus on the adverse effects of ketorolac 3, antiepileptic drugs as a cause of worsening seizures 4, interactions between antiepileptic drugs and other drugs 5, the effect of newer antiepileptic drugs in combination therapy 6, and the mechanisms of action of currently used antiseizure drugs 7.
- However, it can be inferred that ketorolac, being a nonsteroidal anti-inflammatory drug (NSAID), may have a potential interaction with antiepileptic drugs, which could affect seizure control 5.
- Further studies are required to evaluate the potential effects of ketorolac on patients with seizure disorders.