Emergency Medical Minute

Episode 945: Ketorolac vs. Ibuprofen

Feb 24, 2025

Discover the battle of pain relief between ketorolac and ibuprofen. Both are effective, but ibuprofen offers convenience and a lower risk of side effects. Learn why oral ibuprofen can match the relief offered by intramuscular ketorolac, despite the latter’s faster onset. The discussion dives into dosing quirks, adverse effects like gastrointestinal upset, and the importance of lower doses for safety. Cost efficiency and patient comfort take center stage in this enlightening comparison!

03:30

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Quick takeaways

Ketorolac and ibuprofen have equivalent pain relief efficacy, yet oral ibuprofen is preferred due to its comfort and convenience.

Higher doses of ketorolac pose an increased risk of adverse effects without significant improvements in pain management, highlighting cautious prescribing practices.

Deep dives

Comparing Pain Control Efficacy

Cotorlac and ibuprofen have been studied extensively to evaluate their effectiveness in pain control, revealing that they offer comparable analgesic effects. Despite the expectation that Cotorlac, administered intramuscularly (IM), might provide faster relief, patients often prefer the oral form of ibuprofen due to the discomfort associated with the injection. The preference for ibuprofen is also supported by findings indicating that the onset time difference between the two is minimal and not clinically significant. Consequently, it is recommended to prioritize oral ibuprofen for pain management, particularly for patients who can tolerate oral intake.

Comparing Pain Control: Ketorolac vs. Ibuprofen

3min

Contributor: Ricky Dhaliwal, MD

Educational Pearls:

Ketorolac and ibuprofen are NSAIDs with equivalent efficacy for pain in the emergency department

Oral ibuprofen provides the same relief as intramuscular ketorolac
IM ketorolac is associated with the adverse effect of a painful injection
IM ketorolac is slightly faster in onset but not significant
Studies have assessed the two medications in head-to-head randomized-controlled trials and found no significant difference in pain scores

IM ketorolac takes longer to administer and has a higher cost
Ketorolac dosing

Commonly given in 10 mg, 15 mg, and 30 mg doses
However, higher doses are associated with more adverse effects

Gastrointestinal upset, nausea, and bleeding risk

Studies have demonstrated equal efficacy in pain reduction with lower doses

References

Motov S, Yasavolian M, Likourezos A, et al. Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2017;70(2):177-184. doi:10.1016/j.annemergmed.2016.10.014
Neighbor ML, Puntillo KA. Intramuscular ketorolac vs oral ibuprofen in emergency department patients with acute pain. Acad Emerg Med. 1998;5(2):118-122. doi:10.1111/j.1553-2712.1998.tb02595.x

Summarized & Edited by Jorge Chalit, OMS3

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Emergency Medical Minute

Episode 945: Ketorolac vs. Ibuprofen

Podcast summary created with Snipd AI

Quick takeaways

Deep dives

Comparing Pain Control Efficacy

Cost and Dosing Considerations

Remember Everything You Learn from Podcasts