Naproxen vs. Ketorolac
See how Naproxen and Ketorolac compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Naproxen is a long-acting NSAID meant for everyday and chronic pain, while ketorolac is reserved for short-term, moderately severe acute pain.
Naproxen can be taken for months under medical supervision, but ketorolac's total use across all forms (injection, tablet, spray) cannot exceed 5 days.
Both carry FDA boxed warnings for cardiovascular and GI bleeding risk, but ketorolac's warnings are stricter because of its higher potency and injectable use.
Naproxen vs. Ketorolac Drug Summary
Naproxen
Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain, swelling, and stiffness from arthritis, tendinitis, gout, and menstrual cramps. It is taken as an oral tablet or suspension, usually twice a day, and is available both over the counter and by prescription.
Ketorolac
Ketorolac is a potent NSAID used only for short-term treatment of moderately severe acute pain that would otherwise require an opioid. It is given as an injection, oral tablet, or nasal spray, and total use across all forms is limited to 5 days.
Naproxen vs. Ketorolac Side Effects
Naproxen
Ketorolac
Naproxen vs. Ketorolac Dosage
Naproxen
Ketorolac
| STAGE | DOSE | WHEN |
| Starting dose | 250-500 mg twice daily | At the start |
| Maximum dose | Max 1250 mg/day | Day 1 |
| Dose changes | 3 increases | 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 | Days 1-5 |
| Dose changes | 3 increases | As tolerated |
Naproxen
| STAGE | DOSE | WHEN |
| Starting dose | 250-500 mg twice daily | At the start |
| Maximum dose | Max 1250 mg/day | Day 1 |
| Dose changes | 3 increases | 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 | Days 1-5 |
| Dose changes | 3 increases | As tolerated |
Naproxen vs. Ketorolac Indications
Naproxen
Naproxen is an NSAID approved for arthritis pain, tendinitis, bursitis, acute gout, and menstrual cramps. It is also sold over the counter for everyday aches, headaches, and fever. Prescription strength can be used for months or years under a doctor's care.
Rheumatoid arthritis and osteoarthritis
Ankylosing spondylitis
Tendinitis and bursitis
Acute gout flares
Menstrual cramps (dysmenorrhea)
Ketorolac
Ketorolac is an NSAID approved only for short-term treatment of moderately severe pain that would otherwise need an opioid. It is typically started as an injection and may be switched to oral tablets. Total treatment across all forms cannot exceed 5 days.
Moderately severe acute pain (opioid-level)
Short-term postoperative pain
Step-down from IV/IM to oral therapy
Not for chronic or minor pain
Not approved during labor and delivery
Naproxen vs. Ketorolac Pros and Cons
Naproxen
Naproxen's longer half-life allows twice-daily dosing, and its cardiovascular risk profile is considered relatively favorable among NSAIDs. It's sold over the counter as well as by prescription, and generic versions are inexpensive with wide insurance coverage.
Pros
Twice-daily dosing due to longer duration of action
Available over the counter for everyday use
Can be used for months to years for chronic conditions
Widely available and inexpensive as a generic
Cons
Still carries a boxed warning for CV and GI risks with regular use
Not strong enough for severe acute pain needing opioid-level relief
Slower onset than an injectable option
GI side effects can build up with long-term daily use
Ketorolac
Ketorolac delivers opioid-level pain relief without opioid sedation or dependence risk, making it useful for severe short-term pain in hospital and post-surgical settings. Its strict 5-day limit and boxed warnings mean it is reserved for acute situations, not everyday use.
Pros
Opioid-level pain relief without opioid sedation or dependence
Rapid-onset injection option for hospital or ER use
Useful non-opioid choice after surgery
Nasal spray option available for needle-free dosing
Cons
Strict 5-day maximum limit across all forms combined
Boxed warnings for cardiovascular, GI, and renal risks
Not approved for children, minor pain, or before major surgery
Contraindicated during labor and delivery and while nursing
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