Aspirin vs. Ketorolac

See how Aspirin and Ketorolac compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Aspirin is an over-the-counter NSAID used for everyday pain, fever, and long-term heart attack and stroke prevention, while ketorolac is a prescription NSAID reserved for short bursts of severe acute pain.

  • Ketorolac carries boxed warnings for cardiovascular, gastrointestinal, and kidney risks, and its total use across all forms is capped at five days.

  • Aspirin can be taken safely for years under medical guidance, but ketorolac is meant only for brief, opioid-level pain relief after surgery or injury.

Aspirin vs. Ketorolac Drug Summary

Aspirin

Aspirin is an NSAID and salicylate used for pain and fever relief as well as long-term prevention of heart attacks and strokes. It comes in standard, chewable, enteric-coated, and suppository forms, and is usually taken by mouth as needed or once daily depending on the reason for use.

Ketorolac

Ketorolac is an NSAID prescribed for short-term treatment of moderately severe acute pain, at a strength close to opioid-level relief. It is given by injection, taken as an oral tablet, or used as a nasal spray or eye drop, and treatment with any form must not exceed five total days.

Aspirin vs. Ketorolac Side Effects

Aspirin

Most common
stomach upset (up to 10%)
bruising/bleeding (up to 8%)
heartburn (up to 7%)
tinnitus (up to 5%)

Ketorolac

Most common
headache (up to 17%)
abdominal pain (up to 13%)
nausea (up to 12%)
dyspepsia (up to 12%)

Aspirin vs. Ketorolac Dosage

Aspirin

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 325-650 mg every 4 hrs At the start
Maximum dose 75-325 mg once daily If needed
Dose changes 2 increases As tolerated

Ketorolac

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 30 mg IV/IM every 6 hrs Days 1-5
Maximum dose 10 mg every 4-6 hrs PRN If needed
Dose changes 3 increases As tolerated

Aspirin vs. Ketorolac Indications

Aspirin

Aspirin is FDA-approved for temporary relief of minor aches, pains, and fever, and for reducing the risk of heart attack and stroke in people with existing cardiovascular disease. It is also approved for inflammatory joint conditions like rheumatoid arthritis and ankylosing spondylitis. Some doctors also prescribe it off-label for primary heart disease prevention or to lower colorectal cancer risk.

  • Minor aches, pains, and fever

  • Secondary prevention of heart attack and stroke

  • Risk reduction in unstable angina and acute MI

  • Rheumatoid arthritis and ankylosing spondylitis

  • Off-label: primary CVD prevention, colorectal cancer risk

Ketorolac

Ketorolac is FDA-approved only for short-term management of moderately severe acute pain that would otherwise require an opioid, such as after surgery or an injury. Treatment is limited to five days total, combining all forms used. It is not approved for chronic pain, minor aches, or use in children.

  • Moderately severe acute pain, opioid-level relief

  • Short-term use only, five days maximum

  • Available as injection, tablet, nasal spray, or eye drops

  • Not approved for children or minor pain

  • Not for use before major surgery

Aspirin vs. Ketorolac Pros and Cons

Aspirin

Aspirin has been used safely for over a century and is the only common over-the-counter pain reliever with an FDA-recognized cardiovascular protection indication. It's inexpensive and available without a prescription, but long-term use carries real risks of stomach bleeding and, in children with viral illness, Reye's syndrome.

Pros

  • Only OTC pain reliever with FDA-recognized heart attack/stroke prevention use

  • Available without a prescription in many forms (chewable, enteric-coated)

  • Decades of established safety data

Cons

  • Long-term use raises risk of stomach bleeding and ulcers

  • Not safe for children/teens with viral illness (Reye's syndrome risk)

  • Contraindicated in people with NSAID allergy or aspirin-sensitive asthma

  • Tinnitus and kidney injury risk with high-dose or long-term use

Ketorolac

Ketorolac provides pain relief on par with morphine without heavy sedation, making it useful for short bursts of severe pain. It carries boxed warnings for cardiovascular, gastrointestinal, and kidney risks, and its use is capped at five days across every form combined.

Pros

  • Analgesia comparable to morphine without heavy sedation

  • Only injectable NSAID approved for opioid-level acute pain

  • Available in injectable, oral, nasal, and eye-drop forms

Cons

  • Boxed warnings for heart attack, stroke, GI bleeding, and kidney failure

  • Strict 5-day limit on use across all forms combined

  • Not approved for children, labor/delivery, or before major surgery

  • Typically $15 to $50 per month, costlier than aspirin

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