From the Guidelines
Toradol (ketorolac) can be used for acute gout pain, but it is not the preferred first-line treatment due to its potential risks and side effects. It's a non-steroidal anti-inflammatory drug (NSAID) that reduces inflammation and pain associated with gout attacks. The typical dose is 10 mg orally every 4-6 hours as needed for pain, not to exceed 40 mg daily, or 30 mg as a single intramuscular injection. However, Toradol should only be used short-term (5 days maximum) due to risks of gastrointestinal bleeding, kidney problems, and cardiovascular events. Some key points to consider when using Toradol for acute gout include:
- Risks of gastrointestinal bleeding, kidney problems, and cardiovascular events
- Potential interactions with other medications, such as blood thinners
- Importance of taking with food to minimize stomach irritation and ensuring adequate hydration
- Alternative treatment options, such as oral colchicine, oral prednisone, or longer-acting NSAIDs like naproxen, which may be preferred first-line treatments for gout. According to the American College of Physicians guideline on management of acute and recurrent gout 1, corticosteroids, NSAIDs, and colchicine are effective treatments to reduce pain in patients with acute gout. However, the guideline recommends that clinicians choose corticosteroids, NSAIDs, or colchicine to treat patients with acute gout, and that Toradol is not specifically mentioned as a preferred first-line treatment.
From the FDA Drug Label
Carefully consider the potential benefits and risks of ketorolac tromethamine and other treatment options before deciding to use ketorolac. Acute Pain in Adult Patients Ketorolac tromethamine is indicated for the short-term (≤5 days) management of moderately severe acute pain that requires analgesia at the opioid level, usually in a postoperative setting
The FDA drug label does not answer the question.
From the Research
Treatment Options for Acute Gout
- Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat acute gout, with studies showing they can provide relief from pain and inflammation 2.
- Colchicine is also an effective treatment for acute gout, although it can have gastrointestinal side effects 3.
- Corticosteroids are another option for treating acute gout, and may be used when NSAIDs are contraindicated or ineffective 4, 5, 6.
Efficacy of NSAIDs for Acute Gout
- Low-certainty evidence suggests that NSAIDs may improve pain at 24 hours and may have little to no effect on function, inflammation, or adverse events for treatment of acute gout 2.
- Moderate-certainty evidence shows that COXIBs and non-selective NSAIDs are probably equally beneficial with regards to improvement in pain, function, inflammation, and treatment success, although non-selective NSAIDs probably increase withdrawals due to adverse events and total adverse events 2.
- Moderate-certainty evidence shows that systemic glucocorticoids and NSAIDs probably are equally beneficial in terms of pain relief, improvement in function, and treatment success 2.
Toradol (Ketorolac) for Acute Gout
- There is no direct evidence in the provided studies on the use of Toradol (ketorolac) for acute gout.
- However, as an NSAID, it may be expected to have similar efficacy and safety profiles as other NSAIDs used for acute gout, such as ibuprofen or naproxen 2.