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

Most common
Headache (up to 15%)
Dyspepsia (up to 14%)
Nausea (up to 9%)
Flu-like symptoms (up to 10%)

Ketorolac

Most common
Headache (>10%)
Dyspepsia (>10%)
Nausea (>10%)
Abdominal pain (>10%)

Naproxen vs. Ketorolac Dosage

Naproxen

Dosage
Dosage Table
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

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 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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