Toradol Vs Tramadol

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What is Toradol? What is Toradol used for?

Toradol is a Brand name for a nonsteroidal anti-inflammatory drug (NSAID) that contains ketorolac as an active ingredient.  Ketorolac is derivative of a pyrrolizine carboxylic acid structurally related to indomethacin. Ketorolac works by lowering substances in the body that that may cause inflammation and pain. It is one of the most potent drugs from NSAID class.  Ketorolac is only indicated for short-term (5 days or less) treatment of moderate to severe pain.  It is typically given as a pain reliever before or after medical procedures or after surgery. FDA approved ketorolac for next indications:

  • Cystoid Macular Edema
  • Migraine, Acute
  • Ocular Itching
  • Ocular Pain
  • Pseudophakic Cystoid Macular Edema
  • Acute Pericarditis
  • Chronic aphakic cystoid macular edema
  • Inflammatory processes
  • Intraoperative miosis
  • Moderate Acute pain
  • Severe Acute pain

Toradol is available in the form of tablet in dose of 10 mg, and also in the form of solution or liquid for intramuscular injection in doses of 10 and 30 mg.  FDA approved ketorolac in 1989.

What is Tramadol? What is Tramadol used for?

Tramadol is a generic name for a medicine that is used to treat moderate to severe pain. It is sold under the brand names Ultram, Conzip, Rybix ODT and Ultram ER. It is also available in generic form. The extended-release form of this drug is used for around-the-clock treatment of pain. Tramadol extended-release tablets and capsules are not used on an as-needed basis for pain.  It is an opiate analgesic that works by changing the way how brain responds to pain. It may also increase norepinephrine and serotonin levels in the brain. It is often used in combination with acetaminophen. This combination is sold under the brand name Ultram. Tramadol is available in the form of extended-release tablet in doses of 75 mg, 100 mg, 150 mg, 200 mg, 300 mg and 400 mg, immediate-release tablet in doses of 50 mg and 100 mg and extended-release capsules in doses of 100 mg, 150 mg, 200 mg and 300 mg to be taken by mouth. FDA approved tramadol in 1995 and it is originally manufactured by Janssen Pharmaceuticals.

Difference between Toradol and Tramadol

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Toradol and Tramadol are both used as potent pain-reliever medicines. However there are many differences between them. Main differences are that these drugs belong to the different therapeutic groups with different mechanism of action and also have different chemical structures. Toradol is NSAID drug while Tramadol is opioid analgesic.  Ketorolac is derivative of a pyrrolizine carboxylic acid and tramadol has morphine like structure.  Tramadol is undoubtedly more commonly prescribed, but both are mostly used for the same purpose.  Toradol is however a little more potent, so it is also used for migraines and severe pain compared to tramadol. In some rare cases, tramadol may actually be very helpful for the user to proceed through the drug withdrawal process. Both medications are available in intravenous varieties, as well as well oral form.

From the pharmacokinetic standpoint there are also differences. Both drugs are rapidly absorbed after oral administration, but Toradol has bioavailability of almost 100 % compared to tramadol’s bioavailability of 75 %. It has been showed that Toradol works faster than tramadol. Toradol bind to plasma proteins with high affinity of 99 %, while tramadol binds only in 20 % of administrated dose. Both drugs are metabolized in the liver. It has been estimated that less than 50% of a tramadol dose is metabolized. Toradol’s elimination half life time is in range of 3.5 – 9.2 in younger adults and approximately 4.7-8.6 in elderly, while tramadol’s elimination half-life time is about 6.5 hours. Toradol is eliminated via urine in 91.4 % and also biliary in amount of 6.1 %. Tramadol is excreted predominantly in urine in the range of 95 %.

Although these drugs have almost same indications, their side effects profiles are very much different. The biggest problems associated with Toradol used are nausea and vomiting. On the other hand, Tramadol’s biggest negative side effects are its addictive nature and withdrawal symptoms.

Studies showed that after oral use Toradol and Tramadol are equally effective in relieving pain in the first 6 h after dental extraction. However, postoperative pain relieving effects after tramadol use has been found to be more effective than Toradol, while the preoperative pain relieving effects in Toradol has been showed to be better than tramadol.  Both Toradol of 30 mg intramuscular and tramadol 1 mg/kg subcutaneous are effective in renal colic treatment.  When used separately they have an efficacy of approxiamtely 80% and almost 100% when used in combination.  Tramadol has been showed better analgesic properties compared to Toradol for patients undergoing gynaecological laparoscopic procedure.  Toradol and tramadol have showed comparable, effective and inexpensive postoperative analgesia during maxillofacial surgery.

Can you take Toradol and Tramadol together?

In some rare cases, for the treatment of severe pain that can be caused by renal colic, surgery or trauma these drugs may be prescribed together by the doctor. However they should be never used during a long-term period as they may cause serious side effects.

Toradol Vs Tramadol side effects

Toradol possible side effectsTramadol possible side effects
Headache (17%)Constipation (24-46%)
Somnolence (3-14%)Nausea (24-40%)
Dyspepsia (12-13%)Dizziness (10-33%)
GI pain (12-13%)Vertigo (26-33%)
Nausea (12-13%)Headache (18-32%)
Diarrhea (3-9%)Somnolence (7-25%)
Dizziness (3-9%)Vomiting (9-17%)
Pruritus (3-9%)Agitation (7-14%)
Edema (1-3%)Anxiety (7-14%)
Increased blood urea nitrogen (BUN) (3%)Emotional lability (7-14%)
Constipation (<3%)Euphoria (7-14%)
Purpura (<3%)Hallucinations (7-14%)
Increased serum creatinine (2%)Nervousness (7-14%)
Drowsiness (6%)Spasticity (7-14%)
Hypertension (4%)Dyspepsia (5-13%)
Asthenia (6-12%)
Pruritus (8-11%)
Diarrhea (5-10%)
Dry mouth (5-10%)
Sweating (6-9%)
Hypertonia (1-5%)
Malaise (1-5%)
Menopausal symptoms (1-5%)
Rash (1-5%)
Urinary frequency (1-5%)
Urinary retention (1-5%)
Vasodilation (1-5%)
Visual disturbance (1-5%)

Drug-drug interaction Toradol vs Tramadol

Toradol major interactions are with following drugs:

×          aceclofenac

×          acemetacin

×          apixaban

×          aspirin

×          aspirin rectal

×          aspirin/citric acid/sodium bicarbonate

×          celecoxib

×          choline magnesium trisalicylate

×          diclofenac

×          diflunisal

×          etodolac

×          etoricoxib

×          fenbufen

×          fenoprofen

×          flurbiprofen

×          ibuprofen

×          indomethacin

×          ketoprofen

×          lornoxicam

×          meclofenamate

×          mefenamic acid

×          meloxicam

×          methotrexate

×          nabumetone

×          naproxen

×          oxaprozin

×          parecoxib

×          pemetrexed

×          piroxicam

×          probenecid

×          salicylates (non-asa)

×          salsalate

×          sulfasalazine

×          sulindac

×          tacrolimus

×          tolfenamic acid

×          tolmetin

Tramadol major interactions are with following drugs:

×          alfentanil

×          belladonna and opium

×          buprenorphine

×          buprenorphine buccal

×          butorphanol

×          codeine

×          cyclobenzaprine

×          desvenlafaxine

×          dextromoramide

×          diamorphine

×          difenoxin hcl

×          diphenoxylate hcl

×          dipipanone

×          duloxetine

×          eluxadoline

×          fentanyl

×          fentanyl intranasal

×          fentanyl iontophoretic transdermal system

×          fentanyl transdermal

×          fentanyl transmucosal

×          hydrocodone

×          hydromorphone

×          idelalisib

×          isocarboxazid

×          ivacaftor

×          levorphanol

×          linezolid

×          lorcaserin

×          meperidine

×          methadone

×          methylene blue

×          morphine

×          nalbuphine

×          opium tincture

×          oxycodone

×          oxymorphone

×          papaveretum

×          pentazocine

×          phenelzine

×          procarbazine

×          selegiline transdermal

×          sodium oxybate

×          sufentanil

×          tapentadol

×          tedizolid

×          tranylcypromine

×          valerian

×          vilazodone

×          vortioxetine

Tramadol is contraindicated to be used with following drugs:  alvimopan, procarbazine, rasagiline and selegiline.

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About Miljan Krcobic 123 Articles
My name is Miljan Krčobić. I was born on 14th of November 1989. in Negotin, Serbia, where I finished elementary and high school. In June 2015 I graduated from the Faculty of Pharmacy in Belgrade and thus acquired the title Master of Pharmacy. From the July of 2015 to January 2016 I worked in a pharmaceutical company Hemofarm a.d.(Member of STADA group) based in Vrsac, Serbia, as an expert associate for GMP compliance within the sector Quality Assurance. I am currently working in a pharmacy called Zivkovic in Negotin. As a freelancer I write medical articles on Elance and Upwork.