Does Toradol (Ketorolac) lower the seizure threshold?

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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 FDA drug label suggests that ketorolac tromethamine may lower the seizure threshold in some patients, as indicated by reports of sporadic cases of seizures during concomitant use with antiepileptic drugs. However, this is not a direct statement and more of an indirect warning. Therefore, caution should be exercised when administering ketorolac tromethamine to patients with a history of seizure disorders or those taking antiepileptic drugs 1.

From the Research

Toradol (ketorolac) does not typically lower the seizure threshold. Toradol is a non-steroidal anti-inflammatory drug (NSAID) that works by inhibiting prostaglandin synthesis, which helps reduce pain, inflammation, and fever. Unlike some other medications such as certain antibiotics, antidepressants, or stimulants, Toradol has not been associated with an increased risk of seizures in patients without a history of seizure disorders. This makes it a relatively safe option for pain management in most patients, including those with epilepsy or other seizure disorders. However, as with any medication, individual responses can vary, and patients with a history of seizures should inform their healthcare provider before taking Toradol. The typical dosing for Toradol is 10 mg orally every 4-6 hours as needed for pain, with a maximum of 40 mg per day, or 30 mg intravenously/intramuscularly initially, followed by 15-30 mg every 6 hours as needed, with treatment duration not exceeding 5 days due to risk of gastrointestinal and renal side effects.

Some studies have investigated the relationship between NSAIDs and seizure threshold, but the evidence is not directly related to Toradol. For example, a study on tramadol, a different medication, found that it may lower the seizure threshold, but the evidence is not conclusive 2. Another study on psychotropic drugs found that some medications can lower the seizure threshold, but this is not relevant to Toradol 3. A review of nonsteroidal anti-inflammatory drugs in clinical and experimental epilepsy found that NSAIDs may have neuroprotective effects, but the evidence is still inconclusive 4.

In terms of specific evidence related to Toradol, there is limited information available. However, based on the available evidence, it appears that Toradol is not typically associated with an increased risk of seizures. A study on tramadol-related seizures and serotonin syndrome found that tramadol can increase the risk of seizures, but this is not relevant to Toradol 5. Another study on antipsychotic medication and seizures found that some antipsychotic medications can lower the seizure threshold, but this is not relevant to Toradol 6.

In summary, Toradol (ketorolac) does not typically lower the seizure threshold, and it can be a relatively safe option for pain management in most patients, including those with epilepsy or other seizure disorders. However, individual responses can vary, and patients with a history of seizures should inform their healthcare provider before taking Toradol.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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