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

Most common
dyspepsia (3-9%)
nausea (3-9%)
epigastric pain (1-3%)
heartburn (1-3%)

Ketorolac

Most common
dyspepsia (>10%)
nausea (>10%)
abdominal pain (>10%)
headache (>10%)

Ibuprofen vs. Ketorolac Dosage

Ibuprofen

Dosage
Dosage Table
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

Dosage
Dosage Table
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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