Two medicines, side by side
Ketorolac vs tramadol
Ketorolac and tramadol are both labeled for pain. Drugs@FDA records approvals of ketorolac since 1989 and of tramadol since 1995. Pharmacies paid $1.02 per mL (Ketorolac 30 mg/mL vial) and $0.0248 per tramadol HCl 50 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, ketorolac is a cyclooxygenase inhibitor and tramadol an opioid agonist.
Check it at the source: the ketorolac FDA label on DailyMed (effective August 31, 2023); the tramadol FDA label on DailyMed (effective March 5, 2026).
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
Highlights of the tramadol record
Tramadol (Ultram) · label of March 5, 2026
SERIOUS AND LIFE-THREATENING RISKS FROM USE OF TRAMADOL HYDROCHLORIDE EXTENDED-RELEASE TABLETS Addiction, Abuse, and Misuse Because the use of Tramadol hydrochloride extended-release tablet exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death, assess each patient's risk prior to prescribing and reassess all patients regularly for the development of these behaviors and conditions [see Warnings and Precautions ( 5.1 )].
Used for
From the label: indicationsTramadol hydrochloride extended-release tablet is indicated for the management of severe and persistent pain that requires an opioid analgesic and that cannot be adequately treated with alternative options, including immediate-release opioids. […]
On the market
- Earliest approval on file
- March 3, 1995
- Generic labelers
- 39 labelers
- Pharmacy cost
- $0.0248 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 8
Source: FDA drug labels via openFDA (Ketorolac label of August 31, 2023, Tramadol label of March 5, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do ketorolac and tramadol differ on the record?
In FDA's classes, ketorolac is a cyclooxygenase inhibitor and tramadol an opioid agonist.
How each works, in its label's words: Ketorolac, “of ketorolac, like that of other NSAIDs, is not completely understood but may be related to prostaglandin synthetase inhibition.”; Tramadol, “Tramadol hydrochloride extended-release tablet contains tramadol, an opioid agonist and an inhibitor of reuptake of norepinephrine and serotonin.”
Both labels carry a boxed warning; the records quote them.
Generics: ketorolac since 1997; tramadol since 2002 (Drugs@FDA).
DEA schedule: ketorolac none; tramadol CIV.
| Ketorolac | Tramadol | |
|---|---|---|
| Labeled for | Pain | Pain |
| Pharmacologic class | Cyclooxygenase Inhibitor, Nonsteroidal Anti-inflammatory Drug | Opioid Agonist |
| How it works (label) | 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. | Tramadol hydrochloride extended-release tablet contains tramadol, an opioid agonist and an inhibitor of reuptake of norepinephrine and serotonin. |
| Half-life (label) | 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. | n/a |
| Earliest approval on file (Drugs@FDA) | November 30, 1989 | March 3, 1995 |
| First generic approved | May 16, 1997 | June 19, 2002 |
| Generic labelers (NDC) | 60 labelers | 39 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $1.02 per mL (Ketorolac 30 mg/mL vial) | $0.0248 per tablet (Tramadol HCl 50 mg tablet) |
| 12-month price change | -6% | -1% |
| Boxed warning | Yes | Yes |
| Shortage now | In shortage | No current entry |
| Recalls recorded | 24 | 8 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 5,597 | 37,421 |
| DEA schedule | none | CIV |
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?
Tramadol 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 tramadol hydrochloride extended-release tablets with benzodiazepines and/or other CNS depressants, including alcohol (e.g., non-benzodiazepine sedatives/hypnotics, anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics …
Source: FDA drug labels via openFDA
What next?
- Alternatives to ketorolac
- every medicine labeled for the same conditions