Toradol vs Tramadol – Differences, Uses, And Precautions

Pain relief medications are essential for managing moderate to severe discomfort. Two commonly prescribed drugs, Toradol and Tramadol, are often confused due to their similar names and pain-relieving properties. However, they are different in many ways. Here is an overview of pains related to Toradol or Tramadol. Plus, this blog covers the uses, dosages, and risks associated with Toradol vs Tramadol.

Postoperative Pain – An Overview

As the name suggests, this pain arises after surgeries due to the delayed recovery and discharge. The postoperative pain is divided into chronic and acute pain.

Acute & Chronic Pain

Acute pain after surgery is usually temporary, intense form of pain resulting from tissue injury during the surgical procedure. It involves a complex physiological response, including autonomic, psychological, and behavioral reactions. This pain typically subsides as the body heals, but its intensity can vary based on the type of surgery, the individual’s pain threshold, and the management approach.

The acute pain is experienced within 7 days of the surgery. And dull away with the passage of time. In case where this pain lasts for more than 90 days (3 months), it becomes a chronic pain.

What Is Toradol?

Toradol is the brand name for ketorolac, an anti-inflammatory drug introduced for postoperative pain. Catalyzed by cyclooxygenase (COX) enzyme in our body. Toradol is a nonsteroidal anti-inflammatory drug (NSAID) which was introduced for intramuscular injection. This drug is used for short-term relief of moderate to severe pain, often after surgery or injury (postoperative pain). Its active ingredient ketorolac works by reducing inflammation and pain in the body. Unlike some pain relievers that act on the nervous system, Toradol targets the source of pain directly, making it effective for conditions such as sprains, fractures, and post-surgical pain.

Metabolism:

Toradol (Ketorolac) is primarily metabolized by the liver, specifically through the cytochrome P450 enzyme system, with CYP2C9 being the main enzyme involved in its metabolism.

What Is Tramadol?

Tramadol is an opioid-like medication used for moderate pain management. Primarily metabolized by CYP2D6. While it is not classified as a typical opioid, it works similarly by altering the way the brain perceives pain. Tramadol also has a mild effect on serotonin and norepinephrine levels in the brain, which adds to its pain-relieving properties. It’s often prescribed for chronic pain, such as back pain or arthritis.

Metabolism:

Toradol (Ketorolac) is primarily metabolized by the liver, specifically through the cytochrome P450 enzyme system, with CYP2C9 being the main enzyme involved in its metabolism.

Did You Know?

Opioids drug class is derived from or mimics the natural substances from opium poppy plants.

Differences Between Toradol and Tramadol

Mechanism of Action:

Toradol: A nonsteroidal anti-inflammatory drug (NSAID), it works by reducing inflammation, which helps relieve pain. It targets the root cause of pain directly by inhibiting certain enzymes (COX-1 and COX-2) responsible for inflammation.

Tramadol: An opioid-like drug, Tramadol works by altering how the brain and spinal cord interpret pain signals. It also influences certain neurotransmitters (serotonin and norepinephrine), which further aids in pain relief.

Type of Pain Treated:

• Toradol: Best for acute pain like post-surgical or injury-related pain. It is usually used in a hospital or clinical setting for short-term pain management.
• Tramadol: Typically prescribed for chronic pain, such as back pain, arthritis, or conditions requiring long-term pain relief. It is suitable for conditions where inflammation is not the primary concern.

Potential for Addiction:

• Toradol: Has a low risk of addiction because it is not an opioid.
• Tramadol: Carries a higher risk of dependence and addiction due to its opioid-like effects, although it is considered less potent than traditional opioids.

Dosage: Toradol vs. Tramadol

Both Toradol and Tramadol have different dosages depending on the severity of the pain and the specific medical condition. Here’s a general breakdown:

• Toradol: Typically administered via injection (intramuscular) or oral tablets. The maximum recommended dosage is usually for a short period (5 days or less) due to potential side effects on the kidneys and gastrointestinal system.
• Tramadol: Usually taken orally in tablet form. The dosage can vary, but for adults, it’s often started at a lower dose and gradually increased. Tramadol can also be found in an extended-release version for long-term pain management.

According to CDC  “majority of drug overdose deaths (more than six out of ten) involve an opioid.”

Pain Management Alternatives: Toradol and Tramadol

While Toradol and Tramadol are effective, they may not be suitable for everyone. Some people may need alternative medications for pain management:

• NSAIDs: Ibuprofen or naproxen, for mild to moderate pain.
• Acetaminophen (Tylenol): For those who cannot tolerate NSAIDs.
• Opioids: Oxycodone or morphine, though typically used only for severe pain or after surgery.
• Physical therapy: For chronic pain conditions, therapy can help reduce reliance on medication.

Precautions for Toradol and Tramadol

Both Toradol and Tramadol have important safety precautions, and understanding these can help reduce risks.

Toradol:

• Not recommended for those with a history of gastrointestinal bleeding, ulcers, or kidney disease. 
• Should be used for short-term relief (no more than 5 days) due to its effects on the kidneys and gastrointestinal system. 
• Pregnancy: Should not be used, especially during the third trimester, due to risks to the unborn baby. 

Tramadol:

• Caution is required for those with a history of substance abuse, seizures, or liver and kidney disease.
• Addiction: There is a higher potential for abuse, especially in individuals with a history of drug addiction.
• Seizures: Can increase the risk of seizures, particularly at higher doses or when mixed with certain drugs, such as antidepressants.

At home pharmacogenomics or PGx tests, from RPh Labs, give you insights into your genetic makeup. Knowing how your body responds to certain medications helps your doctor prescribe the right drug and the right dosage. Thus, resulting in reduced trial and error.

Boxed Warnings and Serious Risks

Both Toradol and Tramadol come with serious warnings that need to be taken into consideration:

Toradol:

• Risk of gastrointestinal bleeding: Long-term use increases the risk of ulcers and gastrointestinal bleeding. 
• Kidney damage: Toradol can cause kidney problems, especially if used for extended periods. 

Tramadol:

• Risk of addiction: Because it works on the brain like opioids, Tramadol carries the risk of abuse, addiction, and overdose.
• Seizures: High doses or combining Tramadol with other substances (like antidepressants) increases the risk of seizures.

Drug Interactions: Toradol vs. Tramadol

Both medications can interact with other drugs, which may increase side effects or reduce effectiveness.

Toradol:

• Should not be combined with other NSAIDs, blood thinners, or alcohol due to an increased risk of bleeding and kidney damage.
• Be cautious with antihypertensives (blood pressure medications) as Toradol may reduce their effectiveness.

Tramadol:

• Should not be combined with certain antidepressants, antipsychotics, or benzodiazepines due to an increased risk of sedation or seizures.
• Taking Tramadol with alcohol or other central nervous system depressants can increase the risk of overdose.

Conclusion: Which Pain Reliever Is Right for You?

Both Toradol and Tramadol are effective pain-relief medications, but they work in different ways and have distinct uses. Toradol is ideal for short-term acute pain management, especially after surgery or injury, while Tramadol is more suited for reducing pain resulting from renal or biliary colic and labour, trauma, and also for the management of chronic pain of malignant (cancerous tumors / referred for life-threatening conditions as well) or nonmalignant origin (non-cancerous / referred for less risks but still needing medical attention), particularly neuropathic pain.

When deciding between these medications, it’s important to consider factors such as the type of pain, your medical history, and any other medications you may be taking.

FAQs

References:

 

Ketorolac: an anti-inflammatory drug for postoperative pain management

Clinical pharmacology of tramadol

Toradol – FDA boxed warning

 

Disclaimer: This blog is only for informational purposes. Always consult your healthcare specialist before taking any medical action, this includes starting a new medication as well.