Medication kicks a full TN attack in the ass, not available in US,

I had been having non stop TN attacks, both type 1&2, for months. Nothing would cut through the pain, once the attack wa in full swing. I have narcotic pain meds including fentanyl, but once the pain has started, even that is useless.

I went to see a dentist in Mexico who prescribed a medication called: Mavidol. Another name for it is Sinergix. It is 10mg Tramadol (known as Ultram), and 25mg Ketorolac (known as Toradol). It’s delivered in several forms, from injectable to sublingual, but the sublingual form stops my insane TN pain cold in its tracks! I put the pill under my tongue, wait 15 min, and if the pain isn’t all the way gone, I use one more. I have never had an attack that could outlast it. You can’t use it more than twice a week, but for people like me who have insane pain every day, even a twice a week break is incredibly important for my mental health.

Unfortunately for US citizens, it’s unavailable in the US. They say it’s because Toradol is a super anti-inflammatory that can damage your kidneys if taken too often. (I always make sure to drink a lot of water when I take it.) Toradol and Ultram can be bought separately in the US, but only as separate pills, not in the combined or sublingual form. I believe the sublingual delivery system is a lot more powerful than a pill you swallow. Nevertheless, I have asked for an rx for the separate ingredients from my doctor in the US, to see how well they work orally. I brought back as much as I could from Mexico, but since they sell it in packs of only 4 pills at a time, I couldn’t bring much back with me. Buying it online has proven to be difficult, as it seems the combination of the two ingredients is only available from pharmacies in Mexico. If worse comes to worse and I have to go to Mexico 3 times a year to stock up, I will do it. Medical “tourism” is tax deductible and I need a frequent vacation from the pain anyway.

I'm from Canada and so glad you found something that helps you. Toradol was recently banned here for the reason you stated. Stadol is here. I hope it helps others better than it helped me. It just made me dizzy. It's my understanding that Stadol is not given to people outside of the hospital here. I was put on preventative low dose morphine to prevent the pain from coming in the first place, because with my attacks, my vagus nerve gets involved and affects my heart rate, so after my heart stopping a few times from it, they decided the morphine low dose might keep me alive. You might want to discuss a low dose preventative dose of morphine with your Dr. I also have meds for breakthrough pain, and I do all sorts of home remedies to lessen the pain a notch or 2. About once a year it just gets so out of control I have to go to the E,R. to keep me alive, but I am grateful for that preventative dosage since I can't handle the anti-seizure meds.That medicine really is scary. I hope you can find something that won't cause kidney damage. You don't need to deal with that along with TN.

I looked up Ketorolak on It seems to be another NSAIDS medication, and I think you might want to read up on it thoroughly. The following is from the warnings list on

TORADOLORAL (ketorolac tromethamine), a nonsteroidal anti-inflammatory drug (NSAID), is indicated for the short-term (up to 5 days in adults), management of moderately severe acute pain that requires analgesia at the opioid level and only as continuation treatment following IV or IM dosing of ketorolac tromethamine, if necessary. The total combined duration of use of TORADOLORAL and ketorolac tromethamine should not exceed 5 days.

TORADOL (ketorolac tromethamine) ORAL is not indicated for use in pediatric patients and it is NOT indicated for minor or chronic painful conditions. Increasing the dose of TORADOL (ketorolac tromethamine) ORAL beyond a daily maximum of 40 mg in adults will not provide better efficacy but will increase the risk of developing serious adverse events.

As always, be guided by your neurologist or primary care specialist.


The reason why toradol shouldn’t be used for longer than five days straight is because it is associated with a higher risk of stomach ulcers than other NSAIDs. It is quite powerful for pain, however. The injectable form is used often in the ER and it’s been compared to moderate potency opioids without the fear of fueling drug seekers. I was given it IV in the hospital for cellulitis and it worked like a charm. My oral surgeon prescribed the oral form at the maximum daily dosage for my trigeminal neuropathic pain back when we were ruling out dental pathology and it didn’t work that great. I stopped using it after five days because of the risk to my stomach.

I was recently prescribed Ketorolac ( Toradol ) here in Canada Sheila, for a severely infected tooth as well as 9 days of IV antibiotics and another 5 days of oral antibiotics…darn TN pain had masked the tooth issue until it was a big issue,.

In any event I found the Ketorolac to have a positive effect on my increased pain. So much so, I kept a few pills to use on High Pain days…just for a break. The info Red posted above is what I read online after I got the prescription.

Bonnie I’m glad you’ve found some relief, however be careful !!

I'm surprised Mimi. Your comment had me scratching my head. I was SURE I read recently that it would be discontinued. My Dr. even confirmed it, so I did some research. The closest thing I could find is that in July, 40 million vials were recalled. I can find nothing else on it, so I'm stumped where I saw the news on it being banned in the first place. In the article I remember reading about the kidney damage, but I'm glad if you can still get it if you need it. It does nothing for me. It was like taking a sugar pill.

Hi Sheila,

I had it prescribed in August by my oral pain specialist in an emergency situation where a tooth had died, my face was 3x the size within hours and my TN was through the roof ( everyday it’s mid-high) but this was out of control …didn’t sleep for over 2 days. I don’t think it’s something that would work on regular basis and too scary to take for long periods but in addition to my meds and the IV antibiotics it really took the edge off.

My dose was 1 10mg pill up to 3x daily.but I only took 1-2 daily over the course of the infection.
I haven’t taken a pill yet to see if it helps, only if I’m desperate …