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
Ketorolac
Aspirin vs. Ketorolac Dosage
Aspirin
Ketorolac
| 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 |
| 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
| 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
| 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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