From the Guidelines
It is generally safe to take gabapentin and Toradol (ketorolac) together at night, but you should always consult with your healthcare provider before combining these medications. Gabapentin is commonly used to treat nerve pain, seizures, and certain mood disorders, while Toradol is a potent non-steroidal anti-inflammatory drug (NSAID) used for short-term pain management. These medications work through different mechanisms - gabapentin affects neurotransmitters in the brain while Toradol reduces inflammation - so they can complement each other for pain relief, as suggested by the guidelines for the pharmacological management of neuropathic pain 1.
However, Toradol has important restrictions: it should only be used for a maximum of 5 days due to increased risk of serious side effects with longer use, and the typical dose is 10mg every 4-6 hours, not exceeding 40mg daily. The management of acute migraine headache study also highlights the importance of monitoring the use of analgesics like Toradol to avoid rebound headaches 1.
Some key points to consider when taking these medications together include:
- Starting with lower dosages of gabapentin and titrating cautiously to reduce dose-dependent dizziness and sedation, as recommended for calcium channel a-d ligands like gabapentin 1
- Being aware of the potential for increased drowsiness, especially when taking these medications at night
- Monitoring for unusual side effects like severe drowsiness, dizziness, confusion, or stomach pain, and contacting your healthcare provider immediately if you experience any of these symptoms
- Ensuring that you do not exceed the recommended dosage of Toradol and do not use it for more than 5 days to minimize the risk of serious side effects.
It's essential to follow the guidance of your healthcare provider and carefully monitor your response to these medications to ensure the best possible outcome in terms of morbidity, mortality, and quality of life.
From the Research
Combination of Gabapentin and Toradol
- The combination of gabapentin and Toradol (ketorolac) has been studied in various clinical settings, including postoperative pain management 2, 3, 4.
- In a study published in 2010, gabapentin was combined with ketorolac, paracetamol, and dexamethasone to evaluate its analgesic effect after hip arthroplasty. The results showed that the combination group had improved overall pain scores compared to the control group 2.
- Another study published in 2022 used an enhanced recovery after surgery (ERAS) protocol that included gabapentin, celecoxib, and acetaminophen preoperatively, and standing acetaminophen, gabapentin, ketorolac, and tramadol postoperatively. The results showed that the ERAS protocol decreased the use of narcotics and improved pain control in patients undergoing infrainguinal bypass surgery 3.
- However, other studies have found that gabapentin does not improve multimodal analgesia outcomes for total knee arthroplasty or total hip arthroplasty when combined with other analgesics, including ketorolac 4, 5.
Safety and Efficacy
- The safety and efficacy of combining gabapentin and Toradol have not been specifically studied in the context of taking them together at night.
- However, the available evidence suggests that gabapentin and ketorolac can be used together as part of a multimodal analgesia regimen, but the benefits and risks of this combination should be carefully evaluated on a patient-by-patient basis 2, 3, 4, 5.
- It is essential to note that gabapentinoids, including gabapentin, can have adverse effects, such as drowsiness, dizziness, fatigue, and ataxia, especially when used in combination with other medications 6.