Ibuprofen vs. Ketorolac
See how Ibuprofen and Ketorolac compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Ibuprofen is a widely used OTC and prescription NSAID for everyday pain, arthritis, and fever, while ketorolac is a much stronger prescription NSAID reserved for short-term, opioid-level acute pain.
Ketorolac use is capped at 5 total days across all forms combined, while ibuprofen can be used long-term for chronic conditions like arthritis.
Both carry boxed warnings for cardiovascular and gastrointestinal risks, but ketorolac's risks are higher and it adds a boxed warning for kidney injury from volume depletion.
Ibuprofen vs. Ketorolac Drug Summary
Ibuprofen
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain, reduce inflammation, and lower fever in conditions like arthritis, menstrual cramps, and everyday aches. It comes as an over-the-counter tablet, capsule, or liquid, and in higher prescription strengths, usually taken every 4 to 8 hours.
Ketorolac
Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term treatment of moderately severe acute pain that would otherwise require an opioid. It is given as an injection, oral tablet, nasal spray, or eye drop, with total use across all forms limited to five days.
Ibuprofen vs. Ketorolac Side Effects
Ibuprofen
Ketorolac
Ibuprofen vs. Ketorolac Dosage
Ibuprofen
Ketorolac
| STAGE | DOSE | WHEN |
| Starting dose | 400 mg every 4-6 hours | At the start |
| Maximum dose | 300-800 mg 3-4x daily | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg every 4-6 hrs PRN | At the start |
| Maximum dose | 15 mg IV/IM every 6 hrs | If needed |
| Dose changes | 3 increases | As tolerated |
Ibuprofen
| STAGE | DOSE | WHEN |
| Starting dose | 400 mg every 4-6 hours | At the start |
| Maximum dose | 300-800 mg 3-4x daily | If needed |
| Dose changes | 1 increase | As tolerated |
Ketorolac
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg every 4-6 hrs PRN | At the start |
| Maximum dose | 15 mg IV/IM every 6 hrs | If needed |
| Dose changes | 3 increases | As tolerated |
Ibuprofen vs. Ketorolac Indications
Ibuprofen
Ibuprofen treats a range of everyday and chronic pain conditions, from headaches and menstrual cramps to arthritis and fever. It works by blocking inflammatory enzymes and is available without a prescription for common aches or in higher prescription doses for more persistent pain.
Rheumatoid arthritis
Osteoarthritis
Mild to moderate pain
Primary dysmenorrhea
Ketorolac
Ketorolac is reserved for moderately severe acute pain, the kind that would otherwise call for an opioid, and only for a maximum of five days. It is common after surgery or in emergency settings where fast, strong pain relief is needed without an opioid.
Moderately severe acute pain
Opioid-level relief without opioids
Given via IV, IM, oral, or nasal spray
Often used post-surgery in hospitals
Ibuprofen vs. Ketorolac Pros and Cons
Ibuprofen
Ibuprofen fits everyday pain relief and long-term conditions like arthritis, with decades of use behind it and easy access without a prescription. It is far less potent than ketorolac, so it is not a substitute for severe acute pain.
Pros
Available over the counter without a prescription
Can be used long-term for chronic conditions
Comes in tablet, capsule, and liquid forms
Typically $4 to $25 per month without insurance
Cons
Contraindicated for perioperative CABG pain
Too mild for severe, opioid-level acute pain
Requires more frequent dosing for strong pain
Ketorolac
Ketorolac delivers pain relief close to morphine without an opioid, making it useful for short, intense pain episodes such as after surgery. Its strength comes with a strict 5-day limit and a narrower safety margin than ibuprofen.
Pros
Opioid-level pain relief without an opioid
Multiple routes: IV, IM, oral, nasal, ophthalmic
Fast onset comparable to morphine
Less sedating than typical opioid analgesics
Cons
Strict 5-day maximum across all forms combined
Not approved for chronic or minor pain
Contraindicated in advanced renal impairment
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