Two medicines, side by side
Hydromorphone vs ketorolac
Hydromorphone and ketorolac are both labeled for pain. Drugs@FDA records approvals of hydromorphone since 1984 and of ketorolac since 1989. Pharmacies paid $0.219 per hydromorphone 4 mg tablet and $1.02 per mL (Ketorolac 30 mg/mL vial) (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, hydromorphone is an opioid agonist and ketorolac a cyclooxygenase inhibitor.
Check it at the source: the hydromorphone FDA label on DailyMed (effective May 14, 2026); the ketorolac FDA label on DailyMed (effective August 31, 2023).
Highlights of the hydromorphone record
Hydromorphone (Dilaudid) · label of May 14, 2026
SERIOUS AND LIFE-THREATENING RISKS FROM USE OF HYDROMORPHONE HYDROCHLORIDE WARNING: SERIOUS AND LIFE-THREATENING RISKS FROM USE OF HYDROMORPHONE HYDROCHLORIDE See full prescribing information for complete boxed warning. Ensure accuracy when prescribing, dispensing, and administering hydromorphone hydrochloride oral solution. Dosing errors due to confusion between mg and mL can result in accidental overdose and death.
Used for
From the label: indicationsHydromorphone hydrochloride oral solution and hydromorphone hydrochloride tablets are indicated for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. […]
On the market
- Earliest approval on file
- January 11, 1984
- Generic labelers
- 13 labelers
- Pharmacy cost
- $0.219 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 30
Highlights of the ketorolac record
Ketorolac (Toradol) · label of August 31, 2023
Ketorolac tromethamine, a nonsteroidal anti-inflammatory drug (NSAID), is indicated for the short-term (up to 5 days in adults) management of moderately severe acute pain that requires analgesia at the opioid level. Oral ketorolac tromethamine is indicated only as continuation treatment following intravenous or intramuscular dosing of ketorolac tromethamine, if necessary.
Used for
From the label: indicationsCarefully consider the potential benefits and risks of ketorolac tromethamine and other treatment options before deciding to use ketorolac. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals (see WARNINGS ). […]
On the market
- Earliest approval on file
- November 30, 1989
- Generic labelers
- 60 labelers
- Pharmacy cost
- $1.02 per mL
Supply and safety
- Shortage
- In shortage
- Recalls
- 24
Source: FDA drug labels via openFDA (Hydromorphone label of May 14, 2026, Ketorolac label of August 31, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do hydromorphone and ketorolac differ on the record?
In FDA's classes, hydromorphone is an opioid agonist and ketorolac a cyclooxygenase inhibitor.
How each works, in its label's words: Hydromorphone, “Hydromorphone is a full opioid agonist and is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses.”; Ketorolac, “of ketorolac, like that of other NSAIDs, is not completely understood but may be related to prostaglandin synthetase inhibition.”
Half-life, in each label's words: Hydromorphone, “The terminal elimination half-life of hydromorphone after an intravenous dose is about 2.3 hours.”; Ketorolac, “The half-life of the ketorolac tromethamine S-enantiomer was approximately 2.5 hours (SD ± 0.4) compared with 5 hours …”
Both labels carry a boxed warning; the records quote them.
Generics: hydromorphone since 1995; ketorolac since 1997 (Drugs@FDA).
DEA schedule: hydromorphone CII; ketorolac none.
| Hydromorphone | Ketorolac | |
|---|---|---|
| Labeled for | Pain | Pain |
| Pharmacologic class | Opioid Agonist | Cyclooxygenase Inhibitor, Nonsteroidal Anti-inflammatory Drug |
| How it works (label) | Hydromorphone is a full opioid agonist and is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses. The principal therapeutic action of hydromorphone is analgesia. | of ketorolac, like that of other NSAIDs, is not completely understood but may be related to prostaglandin synthetase inhibition. The biological activity of ketorolac tromethamine is associated with the S-form. |
| Half-life (label) | The terminal elimination half-life of hydromorphone after an intravenous dose is about 2.3 hours. | The half-life of the ketorolac tromethamine S-enantiomer was approximately 2.5 hours (SD ± 0.4) compared with 5 hours (SD ± 1.7) for the R-enantiomer. |
| Earliest approval on file (Drugs@FDA) | January 11, 1984 | November 30, 1989 |
| First generic approved | August 23, 1995 | May 16, 1997 |
| Generic labelers (NDC) | 13 labelers | 60 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.219 per tablet (Hydromorphone 4 mg tablet) | $1.02 per mL (Ketorolac 30 mg/mL vial) |
| 12-month price change | +11% | -6% |
| Boxed warning | Yes | Yes |
| Shortage now | In shortage | In shortage |
| Recalls recorded | 30 | 24 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 91,453 | 5,597 |
| DEA schedule | CII | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Hydromorphone label, warnings and precautionsRisks from Concomitant Use with Benzodiazepines or Other CNS Depressants Profound sedation, respiratory depression, coma, and death may result from the concomitant use of hydromorphone hydrochloride oral solution and hydromorphone hydrochloride tablets with benzodiazepines and/or other CNS depressants, including alcohol (e.g., non-benzodiazepine sedatives/hypnotics, anxiolytics, tranquilizers, muscle relaxants …
Source: FDA drug labels via openFDA
What next?
- Alternatives to hydromorphone
- every medicine labeled for the same conditions