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Discussion

Toradol + narcotics and safety?

I just want to double check about this - when I was on orientation, my preceptor told me not to administer IV toradol at the same time as another IV narcotic (I think dilaudid or morphine) because it wasn't "safe". That didn't make any sense to me because toradol is an NSAID -- I understand if her argument was just that pain meds should be spaced out to provide more coverage but she seemed to genuinely think it was a safety issue.

I just want to make sure, are there any safety issues with giving strong doses of NSAIDS simultaneously with a narcotic?

Sometimes patients ask me to give their pain meds together, and if it's a non-narcotic + a narcotic, and I'm very clear with them that that would mean that they would have a longer time in between without being able to get anything, I want to be able to honor their request. If it's two narcotic pain meds, then I always space them about 2 hours apart.

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    we give non-opioid and opioid at the same time all the time-obviously not in the same syringe, but during the same login at a computer ?  Toradol can burn, it needs to be diluted/given slow, but that's the only issue I have ever noticed. 

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    Not sure what specific concern your preceptor would have had in mind.

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    The fallacy is if she did indeed say "ANOTHER IV narcotic" - making the erroneous assumption that Toradol is a narcotic, which it is not.

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    I don’t understand your preceptor’s reasoning, unless it was to watch for separate side effects. However, I have given Toradol many times with an IV opioid (with flushes and/or IV fluid in between). These meds are two separate classes. Toradol is an NSAID but sometimes it can really provide benefit to a patient in severe pain when given in conjunction with an opioid. Toradol is relatively benign with a few exceptions, but won’t give sedating or similar effects to an opioid.

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    Toradol is an amazing pain reliever!! Underrated!

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