The Differences Between Toradol and Tramadol

The Differences Between Toradol and Tramadol

Tramadol is often is referred to as under its trade designation Ultram is an opioid drug that is used to treat pain.

This article will provide comprehensive details about the two U.S. Food and Drug Administration (FDA)-approved prescription drugs.

What Is Toradol?

Toradol is a ketorolac-based nonsteroidal anti-inflammatory medication (NSAID).

Toradol has been approved by FDA for the following purposes:

  • The treatment is short-term for severely acute and moderately painful pain requires robust (opioid-level) pain treatment
  • Following surgery to manage the pain

Toradol is usually injected as an injection into:

  • Vein (intravenous or IV), or
  • Muscle (intramuscular or IM)


The treatment can then be continued by mouth (by the mouth) treatment.

Toradol is associated with risks and should only be used for a period of five day. 1

Sometimes, doctors prescribe medication for usage that isn’t FDA-approved. This is known as off-label prescribing. Toradol is FDA-approved only for use by adults aged with a minimum age of 18.

Some healthcare professionals prescribe this medication off-label to these reasons:

  • Moderate to extreme discomfort in kids 2
  • Pain caused by cancer, which spread (spread) onto the bone 3
  • An acute migraine pain management in an hospital emergency department in the setting of 4

Common adverse effects of Toradol include however, they are not only:

  • Nausea
  • Stomach pain
  • Indigestion
  • Headache1

How Does Toradol Work?

The process of how Toradol works isn’t fully understood.

It’s believed to block your body’s production of prostaglandins..

Prostaglandins are a chemical that causes discomfort and inflammation..

By preventing Prostaglandins’ production Toradol can help reduce the symptoms of inflammation and pain. 1

What Is Tramadol?

Ultram (tramadol) is an opioid painkillerfor extreme pain.

The FDA has approved its use for adults for treating pain that is severe enough to warrant the use of opioid pain medications.

The drug is controlled drug that means it has the possibility of abuse and dependence.

Because of these potential risks, tramadol is recommended to only be used in conjunction with non-opioid drugs:

  • Aren’t strong enough ease the pain
  • Do not allow it. 5


Tramadol is often used off-label to treat following symptoms:

  • Premature ejaculation6
  • Legs-related restlessness syndrome 7.
  • Osteoarthritis pain8
  • Postherpetic neuralgia (skin discomfort following an Shingles inflammation) 9
  • Diabetic neuropathy (nerve damaged by the disease of diabetes) 10

The most common adverse effects of tramadol are and are not limited to the following:

  • Dizziness
  • Vertigo (a spinning sensation)
  • Nausea
  • Vomiting
  • Constipation
  • Headache
  • Sleepiness
  • Itching5

How Does Tramadol Work?

Tramadol’s mechanism of action is not fully comprehended.

It is believed to function through binding opioid receptors.

It also hinders the process of reuptake neurotransmitters in the brain, which convey messages, such as:

  • Norepinephrine
  • Serotonin

Dosage: Toradol vs. Tramadol


Toradol (ketorolac) is an injectable medicine which can be administered IV or intramuscularly.

It’s also available as an oral tablet of 10 milligrams that can be taken orally.

The tablet for oral use should only be taken once the medication has been administered.

Toradol has been approved only for adults. It’s not suitable for teenagers or children under 18 years of age. However, some health professionals recommend it off-label for those populations.

Following the injection has been administered, Toradol oral may be taken in 10 milligrams taken by mouth at intervals of between 4 and 6 hours along with food, as required for discomfort.

Sometimes, a once-in-a-lifetime orally dose of 20 milligrams may be administered prior to the dose of 10 milligrams is taken.

Toradol is best prescribed at the dose that is most effective and for the shortest duration.

The duration for which a patient must take this medication via oral or injectable the maximum is five days.

Seniors or those who are less weight than lbs could be prescribed an equivalency dose.


Tramadol is available as

  • Tablets for immediate release (50 milligrams or 100 milligrams)
  • Tablets with extended-release (100 milligrams 200 milligrams 300 milligrams)
  • Extra-release capsules (100 milligrams 150 milligrams, 200 milligrams 300 milligrams, and 150 milligrams)
  • A liquid for oral consumption that has 5 milligrams in 1 milliliter

The dosage is dependent on the formula as well as other elements.

A typical dose of tramadol that is immediate-release is between 50 and 100 milligrams per day taken orally at intervals of 4 and 6 hours, as required for discomfort.

Similar to Toradol The most dose effective of tramadol is recommended for the shortest period of time.

Adults who are older may receive a dose that is lower.

The medication should be gradually reduced when stopping tramadol, to be able to avoid the withdrawal effects.

Your healthcare provider will supply your with the appropriate tapering plan. 13

Help Is available

Since tramadol’s a controlled substance, it carries the possibility of dependence and abuse. Discuss with your physician regarding safe use of opioids, and be sure to have the prescription for Narcan which could save your life in the event of an accidental overdose. 14 If you require help get help, you can contact the SAMHSA National Helpline for free and confidential contact at the SAMHSA National Helpline at 1-800-662-HELP (4357). 15

Alternatives for Chronic Pain Management

Consult your doctor to discuss the following options to manage chronic pain. The following options are able to be used in conjunction with prescription medications:

  • Acupuncture A comprehensive study of research has revealed that acupuncture can be helpful in treating discomfort due to chronic headache, musculoskeletal or osteoarthritis. The effects lasted for a long period of. 16
  • Dietary intervention for inflammation: A anti-inflammatory diet can help decrease pain and improve the living quality. 17 Consult an licensed dietetic professional (RD or RDN) for more details.
  • Biofeedback Biofeedback is a type of therapy for the mind and body that lets you control certain body functions. It could help with managing pain. 18
  • Exercise Regular (not fatigue-inducing) physical exercise has helped those suffering from the chronic discomfort. 19 Consult your doctor prior to starting any exercise routine that is new.
  • Hypnosis A few studies indicate that hypnosis may help in alleviating pain. 20
  • Meditation The practice of meditation has been helpful in pain relief the quality of life, pain and depression-related symptoms. 21
  • Osteopathic spinal manipulation There is some evidence that revealed that visceral spinal manipulation decreased disability and pain for those who suffer from chronic pain, non-cancer. 22
  • Tai Chi Studies have showed that tai chi was helpful in treating persistent painful. 23
  • The transcutaneous electrical stimulation (TENS): Studies show less pain and after treatment with TENS. 24
  • Yoga Yoga can alleviate discomfort by stretching muscles, strengthening them and controlling the nerve systems. 25

Black Box Warnings

The two Toradol and tramadol carry the black box warning that is the most important warning that is required to be issued by FDA.

Toradol Black Box Warning

The Toradol black box warning informs healthcare providers and people of the following risks/considerations:1


  • Toradol (ketorolac) should be taken for a maximum of five days for moderately severe acute pain.
  • Oral ketorolac should be used for treatment that continues after the administration of IV IM Toradol whenever it is necessary.
  • A maximum period of 5 days is applicable to the combined time of the IV or IM as well as oral Toradol.
  • Toradol is not recommended for use in children.
  • Toradol shouldn’t be used to treat chronic or minor (ongoing) discomfort.
  • The daily maximum dose of Oral Toradol tablet is around 40 mg. A dose higher than this will not ease pain, but could increase the risk for severe adverse consequences.
  • Toradol could cause digestive (GI stomach, intestinal) bleeding as well as perforation (holes) and ulcers (sores). These conditions can be serious and can cause death and may occur at any point during use, and without warning. Toradol should not be taken in patients suffering from specific stomach disorders (see the following section). Adults over the age of 65 are at a higher chance of suffering from serious GI problems.
  • The NSAIDs, such as Toradol, increase the risk of serious heart attacks, such as coronary heart attacks or stroke which could lead to death.
  • Toradol shouldn’t be used prior to or following the procedure for heart bypass (CABG).
  • Toradol is not recommended for those with serious kidney issues or who are at the risk of the development of kidney disease.
  • Since Toradol can affect platelets, it is not advised to use for patients with bleeding or clotting disorders.
  • Toradol is not recommended to reduce pain prior to major surgery.
  • Toradol shouldn’t be used during labor and birth.
  • Toradol is not recommended for those who are taking aspirin or other NSAIDs.
  • Particular individuals may require less doses of Toradol. This includes people who are 65 or more or adults weighing less than 110 pounds and those who have elevated serum creatinine levels..


Tramadol Black Box Warning

The tramadol black box warning informs healthcare providers and people of the following risks/considerations:

  • Tramadol is an Schedule IV controlled substance. It is a potential risk for dependence and abuse that could lead to an overdose and even death. Patients should be evaluated for any risk prior to using tramadol, and should be monitored regularly throughout treatment.
  • A slowed or ineffective breathing pattern could happen, and it could be serious, life-threatening or even lead to death. Patients should be monitored closely particularly at the time of treatment or when the dosage increases.
  • If a child is tempted to take tramadol, an accidental overdose could result in death. Respiratory depression that is life-threatening (slowed and ineffective breathing) and even death have been reported among children who had taken tramadol. A few cases have occurred following the procedure of tonsillectomy or the adenoidectomy (surgically taking out the tonsils or adenoids). In these instances the drug may have been taken off-label as it’s not approved for use in that age bracket.
  • Tramadol is not a prescription drug for use by anyone less than 18 years of age. Tramadol is not recommended for any child under 12 years old or who are younger than 18 following an adenoidectomy or tonsillectomy.
  • Tramadol use during pregnancy could cause a serious condition for the infant, known as neonatal opioid withdrawal. Women who are pregnant should discuss the advantages and risks with their doctor prior to taking tramadol.
  • Tramadol is referred to as being a central nervous system (CNS) depressant. It can cause a slowing of the activity of the nervous system. So, tramadol shouldn’t be used in conjunction in conjunction with other CNS depressants such as sleeping medications, anxiety medicine or any other opioids, except when absolutely necessary and under strict surveillance.


Who Should Avoid Toradol or Tramadol?


Toradol is not suitable for all people.

Before you take Toradol, inform your doctor about:

  • Medical ailments
  • Medical background
  • Family family history

Do not use this medication if intolerant to ketorolac or any NSAID and any active components in Toradol.

Others who shouldn’t use Toradol are: 11

  • Patients with aspirin-induced asthma or the hives
  • People suffering from Samter’s trifecta (a condition in which the person suffers from all three of the following disorders: Asthma, sinus condition that causes nasal polyps and aspirin sensitivity)
  • People who will undergo (or recently had) CABG surgery.
  • Patients who will undergo any major operation
  • People who have severe kidney issues
  • People who have active bleeding
  • People who suffer from an condition that affects blood clotting
  • People who have an undiagnosed past history of GI ulcers or bleeding
  • People suffering from cerebrovascular hemorrhage (stroke caused by bleeding in the brain)
  • People who are depleted in volume (low plasma)
  • Pregnant women (Toradol is not recommended for use from the beginning of 30 weeks of pregnancy. Likewise, at other periods in pregnancy Your healthcare provider must evaluate the benefits and risks)
  • Individuals involved in labor and delivery

For certain people, Toradol may be prescribed with caution only if the doctor determines it to be secure.

There are many situations where the doctor will evaluate the risk and benefit to determine whether Toradol is secure.

If prescribed toradol the patient will be monitored closely.

A few examples are people who have liver, heart, and specific GI issues. 11


Tramadol is not suitable for everyone.

Before taking tramadol your doctor about:

  • Medical medical
  • Medical background
  • Family heritage

Do not take this medication if are sensitive to tramadol, any opioid as well as any active components in this medication.

Other people who shouldn’t use tramadol are the following: 13

  • Patients who have used an MAO inhibitor medication in the last 14 days.
  • People who are extremely fast CYP2D6 metabolisms (these individuals break down certain medications very fast)
  • Teenagers and children younger than 18 years old
  • People who have electrolyte imbalances
  • People suffering from an obstruction in their GI (blockage)
  • People suffering from respiratory depression
  • Patients with severe or acute asthma
  • People who are drunk (from alcohol or other drugs)
  • Suicidal thoughts or behavior
  • People with a history addiction
  • If you are in a state of coma, or an impaired state of consciousness.
  • People suffering from shock from circulatory

Furthermore, patients who have liver or kidney problems shouldn’t take tramadol with extended release.

Tramadol can have to be discussed with care for certain people only when the medical professional determines it’s secure.

There are numerous conditions in which the medical professional will weigh the risks and benefits to determine whether tramadol is suitable for you.

If tramadol has been prescribed, it will be monitored closely.

Examples include those with specific liver, heart or lung problems. 13

Interactions for Toradol and Tramadol

Both drugs come with lengthy lists of possible drug interactions.

The following article will discuss some of the most important interactions between drugs.

Before you take Toradol or tramadol, inform your doctor about any medications you use, such as:

  • Medicines that are prescribed and over-the counter (OTC) medicine
  • Vitamins
  • Supplements

When you are you are taking Toradol or tramadol, you should not take any new medication without the approval of your doctor.

Speak to your physician for more details regarding drug interactions and how they might impact your health.

Toradol Interactions

Do not drink alcohol while taking Toradol.

Alcohol when combined with Toradol could increase the danger of stomach and intestinal bleeding. This could result in death.

Examples of interactions between drugs that involve Toradol include however, they are not restricted by:

  • Blood thinners, such as Jantoven (warfarin)
  • Other NSAIDs
  • Diuretics (“water pills”) like Lasix (furosemide) as well as hydrochlorothiazide
  • Lithium
  • Methotrexate
  • ACE inhibitors, such as Lisinopril or the ramipril
  • ARBs like olmesartan and the valsartan
  • Certain anticonvulsants such as Dilantin (phenytoin)
  • SSRI antidepressants, such as Lexapro (escitalopram) as well as Prozac (fluoxetine)
  • Antidepressants SNRI like Effexor (venlafaxine)


Tramadol Interactions

Discuss with your physician if you should stay away from grapefruit juice if you are taking tramadol.

Do not drink alcohol while taking tramadol.

The combination of tramadol and alcohol may create a variety of complications, including:


  • Blood pressure is very low.
  • Fainting
  • Impairment
  • Breathing is slow
  • Coma
  • Death

A few examples of drug interactions include, but aren’t only limited to 13

  • Jantoven; Coumadin (warfarin)
  • Diuretics
  • Lithium
  • Methotrexate
  • ACE inhibitors
  • ARBs
  • Benzodiazepines, such as Valium (diazepam) as well as Xanax (alprazolam)
  • Antidepressants
  • MAO inhibitors (must be removed from use for at minimum 14 days)
  • Triptans to treat migraine like Imitrex (sumatriptan)
  • Muscle relaxants like Flexeril (cyclobenzaprine)
  • Other opioids such as the oxycodone
  • Sleeping drugs such as Ambien (zolpidem)
  • Wellbutrin (bupropion)
  • Macrolide antibiotics like Biaxin (clarithromycin) as well as Zithromax (azithromycin)
  • Antifungals, such as Diflucan (fluconazole)



Toradol and tramadol both are FDA-approved prescription drugs that pain relief.

Toradol is a nonsteroidal anti-inflammatory medication which is used for treating acute pain up to five days and tramadol is an opioid drug for treating severe pain.

Both medications have warnings and interactions with other drugs which you must be conscious of in actual fact the information on prescribing each drug is so comprehensive that it’s difficult to summarize all the information that is provided.

Your healthcare professional is the only one who can determine the appropriate medication to treat you, based upon the specifics of your medical health history.

Related Articles

Leave a Reply

Back to top button