Is Toradol a Narcotic or Controlled Substance? What to Know

Is Toradol a Narcotic or Opioid Medication?

Fast answer: No.

Toradol, generic name ketorolac, is a nonsteroidal anti-inflammatory drug, or NSAID. While it does offer short-term pain relief like opioids, it does not work by the same mechanism as opioids. Clarifying this distinction is especially important for individuals focused on long-term recovery from substance misuse.

Toradol Basics: What it is and why it’s prescribed

Toradol is the brand name for ketorolac, a prescription nonsteroidal anti-inflammatory drug. NSAIDs reduce pain and inflammation by affecting chemical messengers involved in the body’s inflammatory response.

After surgery or injury, Toradol is commonly prescribed for moderate to severe acute pain management.[3] It is intended for short-term use only and is not appropriate for minor aches or chronic pain conditions. It is considered an effective alternative to opioids.[4] With Toradol, patients can manage their pain without some risks associated with opioid use.

“Narcotic” vs “Opioid” vs “NSAID”

Understanding pain relief classification can reduce confusion and anxiety when medications are prescribed.

• Opioids: These medications, sometimes referred to as narcotics, act primarily on opioid receptors in the central nervous system, or CNS, and throughout the body These medications change how the body perceives pain and can also cause sedation, constipation, and respiratory depression (shallow breathing that leads to a buildup of carbon dioxide and a lack of oxygen)
• NSAIDs (including Toradol): NSAIDs work by reducing the production of prostaglandins, which are chemicals involved in inflammation and pain signaling.[5] NSAIDs do not activate opioid receptors and have a different risk profile, most notably stomach bleeding, kidney damage, and cardiovascular concerns.

How Toradol Works Compared to Opioid Pain Relievers

Toradol reduces inflammation and pain by blocking the production of prostaglandins. Specifically, it works by blocking enzymes involved in prostaglandin production. By lowering these levels, inflammation, swelling, and pain signals are reduced.[6] This mechanism makes Toradol particularly effective for pain that has a strong inflammatory component, such as post-surgical discomfort.[3]

Opioid pain relievers are effective by binding to opioid receptors in the brain, spinal cord, and throughout the body to alter an individual’s perception of pain. This binding changes how pain is perceived. While effective, opioids can suppress breathing, cause sedation, and carry the risks of misuse and dependence. For certain types of acute pain, especially those driven by inflammation, Toradol may provide relief comparable to opioids without opioid-related risks.

What are the risks or side effects of taking Toradol?

Toradol is associated with common side effects of stomach upset and nausea, dizziness, headache, and indigestion. Some individuals experience mild drowsiness from Toradol and should use caution while driving until they are aware of how the medication will affect them.

Potentially Serious Risks:

• Gastrointestinal: Taking Toradol may increase your risk for stomach or intestinal bleeding; if it does occur, the bleeding can happen unexpectedly and may be life-threatening.[7]
• Kidney Issues: Individuals with existing kidney disease or individuals who are dehydrated may develop problems with their kidneys by taking Toradol.[7]
• Cardiovascular: Like all NSAID medications, Toradol may be associated with cardiovascular warnings for heart attacks or strokes if taken for longer than five days or at higher doses.
• Allergic Reactions: Individuals who have an allergy to aspirin or NSAIDs may also develop an allergic reaction when taking Toradol.

Seek medical attention immediately if you notice these symptoms:

• Vomiting blood, black or tarry stools, and pain in the abdomen
• Shortness of breath, sudden weakness, or chest pain
• Rapid gain in weight, decreased amount of urine, or swelling, especially in the lower legs and feet
• Facial swelling, hives, and wheezing

Who should not take Toradol?

Toradol may not be appropriate for patients with gastrointestinal bleeding or a history of ulcers, moderate to severe kidney disease, bleeding disorders, or active bleeding.[7] Doctors usually do not use Toradol in women who are in their third trimester of pregnancy, as it may be harmful to their developing child. You should avoid taking Toradol with other NSAIDs and aspirin, as this will increase the potential for side effects.

How long can you take Toradol?

Toradol is only intended for short-term use. The prescribing guidelines for Toradol limit its total use to five days or less for injection, tablet, or a combination of both.[7] This prescribing guideline exists to protect patients against the greater risk of serious side effects associated with higher doses and longer use.[7]

Drug Interactions and Safety Tips

When Toradol is taken with other NSAIDs and/or aspirin, the risk of gastrointestinal bleeding will be increased. Blood thinners and some antiplatelet medications will also increase the risk of gastrointestinal bleeding when combined with Toradol. The use of alcohol will cause additional irritation to the stomach lining of individuals taking Toradol, with greater risk for GI bleeding.

Patient Checklist Before Starting Toradol:

Before taking Toradol, patients need to communicate with their clinician regarding their:

• Kidney disease history
• History of stomach ulcers
• History of heart disease
• Allergy to NSAIDs
• Pregnancy or plans to become pregnant

Open communication supports safe and effective care and allows for each patient’s unique pain management needs to be met.

Alternatives to Toradol

Individuals have many options for pain relief, including over-the-counter NSAIDs, prescription NSAIDs, acetaminophen, and opioids, depending on the type of pain, a person’s health history, and the guidance of their clinician. For those who are in recovery, non-opioid medications combined with behavioral therapy, mindfulness (the practice of intentionally focusing on the present moment), and holistic care can assist with pain management and overall wellness.