Comparison Table: Naproxen vs Ketorolac
| Category | Naproxen | Ketorolac |
|---|---|---|
| 1. Drug Class | NSAID (Nonsteroidal Anti-inflammatory Drug) | NSAID (Nonsteroidal Anti-inflammatory Drug) |
| 2. Brand Names | Aleve, Naprosyn | Toradol |
| 3. Route of Administration | Oral, topical | Oral, IM, IV, intranasal |
| 4. Onset of Action | 1–2 hours | 30–60 minutes (IV/IM); faster than oral naproxen |
| 5. Duration of Action | 8–12 hours | 4–6 hours |
| 6. Potency | Moderate | High (very potent NSAID) |
| 7. Use Duration | Suitable for long-term use (with caution) | Short-term only (max 5 days) |
| 8. Primary Indications | Arthritis, menstrual cramps, gout, pain, fever | Moderate to severe short-term pain (e.g. post-op) |
| 9. Contraindications | GI ulcers, kidney disease, aspirin allergy | Same as naproxen + severe dehydration, bleeding disorders |
| 10. Renal Safety | Less nephrotoxic than ketorolac | High risk of kidney damage with prolonged use |
| 11. GI Toxicity | Moderate | High GI bleeding risk (more than naproxen) |
| 12. Cardiovascular Risk | Possible increase in CV events | Higher risk of MI, stroke, especially with prolonged use |
| 13. Drug Interactions | Interacts with anticoagulants, corticosteroids, other NSAIDs | Similar interactions but more critical due to potency |
| 14. Pregnancy Safety | Avoid in 3rd trimester (Category C/D) | Avoid in pregnancy, especially late trimester (Category C/D) |
| 15. Pediatric Use | Approved for children >2 years (with specific doses) | Not recommended in children <17 years |
| 16. Elderly Use | Use with caution (lower dose) | Use with extreme caution (higher GI/kidney risk) |
| 17. Cost | Low cost; available OTC | Prescription only; more expensive |
| 18. Availability | OTC and prescription | Prescription only |
| 19. Anti-inflammatory Power | Moderate | Stronger anti-inflammatory and analgesic effect |
| 20. Use in Surgery/Pain | Used less for post-surgical pain | Often used for acute pain post-surgery (limited to 5 days max) |
Indications
| Drug | Indications |
|---|---|
| Naproxen | Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout, fever, tendonitis, bursitis, headache, back pain, menstrual cramps, mild-to-moderate pain |
| Ketorolac | Postoperative pain, short-term management of moderate-to-severe acute pain (e.g. dental, musculoskeletal, renal colic, post-op) |
Contraindications
| Drug | Contraindications |
|---|---|
| Naproxen | Active GI bleeding, peptic ulcer disease, NSAID allergy, severe kidney/liver impairment, pregnancy (3rd trimester), bleeding disorders |
| Ketorolac | All naproxen contraindications plus: active bleeding (e.g. intracranial, GI), cerebrovascular bleeding, concurrent use of other NSAIDs, prolonged use >5 days |
Dosage
| Drug | Adult Dosage |
|---|---|
| Naproxen | 250–500 mg orally every 12 hours (max 1000–1500 mg/day depending on formulation) |
| Ketorolac | IV/IM: 15–30 mg every 6 hours; PO: 10 mg every 4–6 hours (max 40 mg/day); max duration: 5 days (total) |
Warning Signs (Stop Use If)
| Drug | Warning Signs |
|---|---|
| Naproxen | Black/tarry stools, vomiting blood, severe stomach pain, shortness of breath, chest pain, vision changes, swelling |
| Ketorolac | Same as naproxen plus: severe dizziness, fainting, kidney changes (little urine), unusual bleeding, jaundice |
Which One is Best and Safe?
| Criteria | Preferred Drug | Explanation |
|---|---|---|
| Short-Term Severe Pain | Ketorolac | Stronger, faster-acting; good for post-op or acute injury but short-term use only |
| Long-Term Pain Management | Naproxen | Safer for prolonged use; less risk to kidneys and GI lining |
| Over-the-Counter Use | Naproxen | Available without prescription; suitable for self-medicated mild/moderate pain |
| Elderly or Kidney Risk | Naproxen (lower dose) | Lower risk to renal function if used correctly |
| Overall Safety | Naproxen (for general public) | Fewer restrictions, wider safety margin, more flexibility in dosage and duration |
