Toradol and ibuprofen: Key differences, uses, safety, and costs

In this article:

• What are the main differences between Toradol and ibuprofen?
• Conditions treated by Toradol and ibuprofen
• Efficiacy
• Cost and coverage
• Side effects
• Interactions
• Warnings
• FAQs

In this article

• What are the main differences between Toradol and ibuprofen?
• Conditions treated by Toradol and ibuprofen
• Efficiacy
• Cost and coverage
• Side effects
• Interactions
• Warnings
• FAQs

Toradol and ibuprofen are two nonsteroidal anti-inflammatory drugs indicated for the treatment of pain and inflammatory conditions. Nonsteroidal anti-inflammatory drugs, commonly known as NSAIDS, are commonly used to treat muscle pain, arthritis, menstrual pain, and migraines, among other conditions. NSAIDs are also used as antipyretics to lower body fevers. NSAIDs work by inhibiting an enzyme known as cyclooxygenase, or COX for short. There are different COX enzymes that play a role throughout the body, and COX is important in the processes of inflammation and fever. While Toradol (ketorolac)  and ibuprofen are both NSAIDs, there are some important differences between them, and different recommendations for when they are appropriate.

What are the main differences between Toradol and ibuprofen?

Conditions treated by Toradol and ibuprofen

Toradol and ibuprofen may belong to the same major drug class, but they are quite different in how they are accessed and utilized.

Toradol is a prescription-only NSAID indicated for the short-term treatment of moderate or moderately severe pain that requires analgesia at the opioid level. It is also used off-label to treat migraines that have not been responsive to first-line treatments. Toradol treatment should begin with an intramuscular or intravenous dose or series of doses. This can be followed by oral therapy. It is important that the total duration of treatment with Toradol does not exceed 5 days at a time.

Ibuprofen is both an over-the-counter (OTC) and prescription NSAID pain reliever used for a broader variety of conditions. These include mild to moderate pain, moderate to severe pain (as an adjunct to opioid treatment), arthritic conditions, dysmenorrhea, fever, and migraine. It is also used off-label in conditions such as frostbite, cystic fibrosis, gout, and pericarditis. 

Is Toradol or ibuprofen more effective?

Toradol and ibuprofen have been compared directly for a few different indications. Researchers compared the efficacy of a 5-day treatment of oral ibuprofen, ketorolac, and diclofenac for acute, in a clinical trial evaluating nonradicular lower back pain. Results were very similar between the three drugs, with no one drug showing a clear advantage in pain relief. The intravenous forms of both drugs were compared in a separate trial looking at perioperative pain control following open abdominal hysterectomy surgery. Patient satisfaction ratings were slightly higher in the ketorolac group, but pain scores were found to be similar.

While pain relief may be similar, Toradol and ibuprofen differ in their profile of adverse effects, especially gastrointestinal effects. NSAIDs are known to cause gastrointestinal irritation and damage, and this effect appears to worsen with long-term and consistent use. Both Toradol and ibuprofen inhibit both the COX-1 and COX-2 pathways, with COX-1 receptors being much more predominant in the gastrointestinal tract. Despite that similarity, Toradol appears to be more harsh and linked to more damage to the intestinal tract than ibuprofen. This is one reason why Toradol use is specifically limited to 5 days at a time. Both drugs should be taken with food to help offset some of the acidity and irritation caused by these drugs. This could be an important factor when choosing between Toradol and ibuprofen for pain relief.

This is not intended to be medical advice, and only your healthcare professional can decide which of these is right for you. They may take into account your ability to get a first-dose injection with Toradol, which is typically done in the provider’s office. This is not necessary with ibuprofen. Another factor to consider is how long you expect treatment to be needed. Toradol must be discontinued after 5 days even if the pain has not been resolved. Ibuprofen can be used longer than 5 days, though you want to keep the duration as short as possible to avoid unwanted adverse events.

Coverage and cost comparison of Toradol vs. ibuprofen

Prescription drug insurance plans do typically cover the generic version of Toradol, known as ketorolac, as well as ibuprofen. Plans may impose quantity limits per fill. For example, because Toradol is only to be used for 5 days, many plans will only cover 5 days at a time. Should another treatment be needed at a later time, a separate prescription refill would need to be filled. Both NSAID drugs are available generically and typically available on the lower copay tier. The price you pay may be affected by deductibles or other factors with your insurance plan.

Luckily, whether you are insured or uninsured, you can always find the lowest possible cash price of either drug at SingleCare.com. SingleCare will also let you know what Toradol and ibuprofen cost at your nearby pharmacies up front. This saves you from calling or going door to door to find the best price.

Common side effects of Toradol vs. ibuprofen

Toradol and ibuprofen are both NSAID pain-relieving drugs. Because they belong to the same drug class, their side effects are similar but may vary in rate of occurrence and severity. Toradol comes with a boxed warning from the Food and Drug Administration (FDA) due to its risk for gastrointestinal bleeding, gastric perforation, and peptic ulcers. There is also a risk of cardiovascular thrombotic events due to the effect on blood platelets. This can lead to heart attacks and strokes, which can be fatal. Abdominal pain and dyspepsia are the adverse events that occur most commonly with Toradol use.

Ibuprofen carries a similar FDA-boxed warning for thrombotic events and gastrointestinal risks as Toradol. Nausea, abdominal pain, and heartburn are the most common side effects of ibuprofen.

Other side effects of NSAID drugs which can occur with either Toradol or ibuprofen use include:

• Drowsiness
• Dizziness
• Headache
• Injection site irritation
• Rashes

This is not intended to be a complete risk of all adverse events that can occur with Toradol or ibuprofen. You should consult your pharmacist or healthcare provider for more information.

Drug interactions of Toradol vs. ibuprofen

Toradol and ibuprofen should be avoided with other NSAIDs as their concomitant use can increase the risk for serious adverse events. This can include aspirin, Aleve (naproxen), and diclofenac. NSAIDs should be used very cautiously with blood-thinning agents, as this can result in an inability to form blood clots when needed. This includes warfarin, aspirin, and heparin. NSAIDs can also diminish the effect of hypertensive medications such as ACE inhibitors, which could allow your blood pressure to increase. ACE-inhibitors include lisinopril, captopril, and fosinopril, to name a few.

If a patient is on a diuretic, specifically furosemide or hydrochlorothiazide, the effects of the diuretic may be decreased by Toradol and ibuprofen. Patients, especially those with a history of renal disease, should be monitored closely for renal failure. NSAIDs can increase lithium levels for patients taking lithium. Patients taking ketorolac in addition to medications for seizures may also experience an increase in seizure activity while on ketorolac.

This list of interactions is not intended to be all-inclusive. Please consult your prescriber or pharmacist for a complete list of potential drug interactions.

Warnings of Toradol and ibuprofen

The FDA’s boxed warning for Toradol also encompasses warnings for patients with a history of bleeding disorders or who already have an active bleed. Giving Toradol in this condition is high risk and should be avoided. Patients who have renal impairment or a history of renal disease should not take Toradol. Toradol should not be used in labor and delivery due to adverse effects on fetal circulation and the inhibition of uterine contractions.

NSAIDs generally should be avoided in patients with renal dysfunction, including Toradol and ibuprofen. Make sure to tell your healthcare provider if you have a history of kidney disease. Before taking NSAIDs. Because some strengths of ibuprofen can be purchased without a prescription, be sure to read the label warnings completely before taking. NSAIDs can also lead to new or worsening hypertension, fluid retention, and skin reactions. 

Frequently asked questions about Toradol vs. ibuprofen

What is Toradol?

Toradol (ketorolac) is a prescription nonsteroidal anti-inflammatory drug indicated for the treatment of moderate to moderately severe pain requiring opioid analgesia. 

What is ibuprofen?

Ibuprofen is a generic nonsteroidal anti-inflammatory drug available both in prescription and OTC strengths. Ibuprofen has a broader range of approved uses including mild to moderate pain, moderate to severe pain (as an adjunct to opioid treatment), arthritic conditions, dysmenorrhea, fever, and migraines. 

Are Toradol and ibuprofen the same?

Toradol and ibuprofen are both nonsteroidal anti-inflammatory drugs, but they are not quite the same. Toradol is prescription only and is generally used for more moderate to severe pain. It can only be given orally following an intravenous or intramuscular administration. Ibuprofen can be accessed with or without a prescription and is generally used for mild to moderate pain conditions.

Is Toradol or ibuprofen better?

Data from clinical studies suggests that Toradol and ibuprofen are similar in their ability to provide pain relief. Prescribers may consider other factors such as length of treatment needed or the ability to provide the first dose via injection when determining which medication is best for their patient.

Can I use Toradol or ibuprofen while pregnant?

NSAID drugs are generally discouraged in pregnancy due to the platelet inhibition they cause and the risk of bleeding. NSAIDs can also negatively affect the renal health of the fetus. Toradol is contraindicated in the third trimester of pregnancy as well as during labor and delivery. Ibuprofen use is also contraindicated in the third trimester. Use of any NSAID prior to the third trimester should only be done if the benefits far outweigh the risks. 

Can I use Toradol or ibuprofen with alcohol?

NSAID drugs like Toradol and ibuprofen are linked to an increased risk of gastrointestinal bleeding. Combining NSAIDs with alcohol increases that risk even more. In fact, just one drink per day while taking NSAIDs can increase your risk of GI bleeding by up to 37%.

What is the OTC equivalent of Toradol?

There is no exact equivalent to Toradol available over the counter. However, some lower-dose NSAIDs are available without a prescription. These include Aleve (naproxen), Motrin or Advil (ibuprofen), and aspirin. Over-the-counter NSAIDs are not generally adequate for moderate or moderately severe pain.