let me just preface this by saying i am a nursing student doing my ob rotation right now.
toradol is apparently a very common medication used in l&d. the hospital i am at for clinical uses it all the time and i have heard other classmates say their hospitals use it too. yesterday i had a patient in the recovery room after a c-section. she was breast feeding and had some break through pain (she had duramorph in her spinal). the patient had a standing order for toradol and the nurse gave her 30mg. i researched the medication and found that it has a lot of black box warnings. it is contraindicated in l&d because it can inhibit uterine contractions and it is contraindicated in nursing mothers because potential adverse affects can be passed on to the babies less than 1 month old. it is also contraindicated if the patient is at a high bleeding risk because it inhibits platelet function. so it sounds to me like this is the worst possible drug to be using in these situations and hospitals are using it as their go-to drug! can someone please explain to me why? with just this knowledge, i don't feel comfortable giving it.[color=#663366]
Specializes in Nurse Leader specializing in Labor & Delivery.
We use Toradol for post-op C/S all the time; however, they max out at 4 doses because it's rough on the kidneys (or so I was told). The breast milk transfer issue is not taken into consideration because mom is just not making that much milk yet. Same with the Dilaudid and morphine PCAs we use all the time - OK for newborns who are just getting colostrum, but not if mom's milk is in.
Maternal intake of narcotics (as well as Toradol) is considered safe for breastfeeding babies at all stages. It may cause sedation in the infant.
On a side note - I personally love Toradol. I was discussing Toradol with an OB I work with this week and he told me about Sprix - it's a Toradol Nasal spray that is available by prescription. This is very exciting to me, as I hope it means that I may be able to avoid visits to Urgent Care for shots of Toradol for my migraines :)
klone, MSN, RN
14,857 Posts
Maternal intake of narcotics (as well as Toradol) is considered safe for breastfeeding babies at all stages. It may cause sedation in the infant.