From the Guidelines
If someone is allergic to aspirin, they are likely allergic to Toradol (ketorolac) as well, due to cross-reactivity between non-steroidal anti-inflammatory drugs (NSAIDs). These medications belong to the same class of drugs and inhibit an enzyme called cyclooxygenase (COX), which can lead to increased production of leukotrienes in susceptible individuals, causing symptoms like hives, facial swelling, wheezing, or even anaphylaxis 1. The allergic reaction to aspirin could also be triggered by Toradol, as they share similar mechanisms of action.
Some key points to consider:
- Cross-reactivity between NSAIDs is common, and patients with an aspirin allergy should exercise caution when taking other NSAIDs like Toradol 1.
- Alternative pain relievers that may be safer include acetaminophen (Tylenol) or, in some cases, COX-2 selective inhibitors like celecoxib (Celebrex), though these should only be used under medical supervision after careful consideration of the specific allergy history 2.
- Aspirin desensitization is an option for patients with aspirin-exacerbated respiratory disease (AERD), and it can improve clinical outcomes for both upper and lower respiratory tract disease 2.
- Patients with a known aspirin allergy should inform all healthcare providers about this allergy to avoid potential adverse reactions.
In terms of management, avoiding Toradol and other NSAIDs is recommended for patients with an aspirin allergy, unless medically supervised and deemed necessary. Instead, alternative pain management options should be explored, taking into account the individual's specific allergy history and medical needs 3, 1, 2.
From the FDA Drug Label
Ketorolac tromethamine should not be given to patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients
- Allergy to Aspirin and Toradol: If someone is allergic to aspirin, they may also be allergic to toradol (ketorolac tromethamine) due to the risk of cross-reactivity and anaphylactic-like reactions.
- Key Consideration: Patients with a history of asthma, urticaria, or allergic-type reactions to aspirin or other NSAIDs should not be given ketorolac tromethamine 4.
- Clinical Decision: It is recommended to exercise caution and avoid administering toradol to individuals with an aspirin allergy, as the risk of a severe reaction cannot be ruled out.
From the Research
Allergy to Aspirin and Toradol
- If someone is allergic to aspirin, they may also be allergic to other nonsteroidal anti-inflammatory drugs (NSAIDs) due to cross-sensitivity 5.
- Toradol, also known as ketorolac, is an NSAID that may cause cross-reactions in patients with aspirin hypersensitivity 5.
- Studies have shown that patients with aspirin hypersensitivity may develop cross-reactions to other NSAIDs, including ketorolac 5, 6.
- However, it is essential to note that not all patients with aspirin hypersensitivity will react to toradol, and the severity of the reaction can vary 5, 6.
Diagnosis and Management
- The diagnosis of aspirin and NSAID-induced hypersensitivity reactions is crucial for patient safety and management 6.
- Aspirin and NSAID challenges are considered the criterion standard for diagnosing these hypersensitivity reactions, although a clear clinical history can also be used in some cases 6.
- Patients with a history of aspirin allergy should be cautious when using toradol or other NSAIDs, and medical supervision is recommended 5, 6.