What Is The Difference Between Toradol And Tramadol

In our latest question and answer, the pharmacist discusses the difference between two pain medications, Toradol (ketorolac) and tramadol.

Mar 21, 2018

Nick asked

What is the difference between Toradol (ketorolac) and tramadol?

Answer

While both Toradol (ketorolac) and tramadol are prescription medications used for pain, they are classified differently and work in very different ways. Below, we discuss the difference between the two medications.

Toradol (Ketorolac) Information

Toradol (ketorolac) is a nonsteriodal anti-inflammatory (NSAID). It is considered to have stronger analgesic and anti-inflammatory effects than most other NSAIDs, including ibuprofen and naproxen. Unfortunately, ketorolac is associated with a higher risk of stomach problems and ulcers than other NSAIDs. Due to this, the tablet form is only to be used as a continuation therapy after receiving the injectable formulation, for up to 5 days. The injectable form can be given intramuscular or intravenously. 

Toradol is not classified as a controlled substance.

Toradol is available as:

  • Nasal spray (SPRIX)
  • Othalmic solution (Acular, Acuvail),
  • Oral tablet 
  • Injectable

Common side effects include but are not limited to:

  • Diarrhea
  • GI bleeding
  • Headache
  • Abdominal pain
  • Iritis
  • Ocular infection
  • Ocular pain
  • Ulcer
  • Vomiting

Tramadol Information

Tramadol is a synthetic analog of codeine and is classified as an opioid analgesic. While the majority of analgesic effect is thought to be due to its activity on opioid receptors, it also is thought to increase the neurotransmitter norepinephrine.

Tramadol is available as:

  • Oral biphasic capsule (Conzip)
  • Oral tablet
  • Oral extended release tablet
  • Topical powder (EnovaRX)

Tramadol is indicated for use in treating moderate to severe pain. The dose of tramadol should be slowly titrated to increase tolerability and may be given with or without food. The different forms or extended release tramadol are not dosed the same and should not be interchanged. The orally disintegrating  tablets should be dissolved on the tongue not chewed or crushed. 

Tramadol is classified as a controlled substance.

Common side effects of tramadol include but are not limited to:

  • Constipation
  • Dizziness
  • Drowsiness
  • Headache
  • Nausea
  • Vertigo
  • Flushing
  • Dyspepsia
  • Agitation

Summary

  • Toradol (ketorolac) is classified an a NSAID and has potent analgesic and anti-inflammatory effects. It is not a controlled substance.
  • Tramadol is an opioid analgesic and is thought to increase norepinephrine levels as well. It is classified as a controlled substance.

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