Ibuprofen Equivalent of Toradol 30mg q6h
The equivalent dose of ibuprofen to ketorolac (Toradol) 30mg every 6 hours is 800mg of ibuprofen every 6 hours. 1
Dosing Equivalence Rationale
According to the American Family Physician guideline, ketorolac (Toradol) 60mg IM is considered equivalent in analgesic efficacy to ibuprofen 800mg orally given every six hours 1. Since the question asks about ketorolac 30mg q6h (which is half the maximum IM dose), the equivalent ibuprofen dose would be 800mg every 6 hours.
The guideline specifically outlines the following dosing parameters:
- Ibuprofen: 400 to 800 mg every six hours (maximum initial dose: 800 mg, maximum daily dose: 2.4g)
- Ketorolac: 60 mg IM every 15 to 30 minutes (maximum daily dose: 120 mg, not to exceed five days of treatment)
Important Clinical Considerations
Efficacy Comparison
- Both medications have similar efficacy ratings (rated "3" on the efficacy scale in the guideline) 1
- Recent research (2024) indicates that IV ibuprofen and IV ketorolac have comparable efficacy in managing acute postoperative pain 2
Safety Considerations
- Duration limitations: Ketorolac should not be used for more than 5 days due to increased risk of adverse effects 1, 3
- Maximum daily dosage:
Contraindications (for both medications)
- Aspirin/NSAID-induced asthma
- History of peptic ulcer disease
- GI bleeding or perforation
- Advanced renal impairment
- Cerebrovascular bleeding
- Coagulation disorders 3
Special Populations
- Elderly patients (≥65 years): Higher risk of adverse effects; require reduced dosing 3
- Patients with renal impairment: At risk of acute renal failure 3
- Patients <50 kg: Require dose reduction 3
- Patients with cardiovascular disease: At risk of thrombotic events 3
- Patients on anticoagulants: Increased bleeding risk 3
Monitoring Recommendations
When switching from ketorolac to ibuprofen, monitor for:
- Blood pressure
- Renal function (BUN, creatinine)
- Liver function
- Complete blood count
- Coagulation profile
- Fecal occult blood 3
Practical Application
When transitioning from ketorolac to ibuprofen:
- Ensure the patient can tolerate oral medications
- Start with ibuprofen 800mg every 6 hours
- Do not exceed 2.4g of ibuprofen daily
- Monitor for GI side effects, which may be less common with ketorolac compared to ibuprofen 4
- Consider that ibuprofen may cause more stomach irritation than ketorolac (26% vs 5% in one study) 4
Remember that while these medications are considered equivalent in analgesic effect at the doses mentioned, individual patient response may vary, and the safety profile differs between the two drugs.