★★★★★ 4.7 out of 5 (48 reviews)
RX: Pain Gel
0.5% ketorolac gel. Prescription-strength topical NSAID applied directly to the site of pain. No pills. No GI side effects. One jar lasts up to 6 months.

This is prescription-strength, it requires a prescription because it's that strong. Provider review included after checkout.

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$116/mo
Free shipping. Cancel anytime.
Pain relief compounds with consistency. Most customers feel the biggest difference applying 3–4 times daily for the first week.
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Compounded specifically for you at an FDA-registered US pharmacy
If your provider determines this isn't right for you, you pay nothing.
★★★★★

“Haven't needed a pill in almost two months.”

JOSE CARLOS · 54 · SAN FRANCISCO, CA · VERIFIED BUYER

Prescription strength

For pain pills don't reach

Six places ketorolac works.

Lower back painLower back pain

Targets acute flare-ups, chronic stiffness, sciatic-area pain

Knee & joint arthritisKnee & joint arthritis

Treats osteoarthritis flares, end-of-hike stiffness, post-run joint pain

Wrist & tendonWrist & tendon

Relieves carpal tunnel, tennis elbow, arthritis-stiff hands

Strain & sprainStrain & sprain

Reduces inflammation from pulled muscles, sprains, soft-tissue injury

Neck & shoulderNeck & shoulder

Eases chronic neck pain, frozen-shoulder ache, pinched-nerve flares

TMJ & jaw painTMJ & jaw pain

Calms severe clenching, jaw-joint inflammation, chronic facial pain

What it does in your body

Ketorolac is a prescription-only NSAID used in hospitals for moderate-to-severe pain, and significantly more potent per milligram than the ibuprofen or naproxen you can buy over the counter. Applied topically, it blocks the COX enzymes that drive inflammation right at the painful tissue. No pill. No gut. No systemic load on your blood pressure or kidneys.

It's a match if you

  • Have arthritis or chronic joint pain that ibuprofen and naproxen barely touch
  • Can't take daily oral NSAIDs because of GI side effects, blood pressure, or kidney concerns
  • Want prescription-strength relief targeted to one spot, not a pill that goes everywhere
Simple Online Process
How to Get Started
No office visit. No waiting room. Prescription-strength relief delivered to your door.
1
Order
Place your order online. Choose Subscribe & Save or one-time purchase.
2
Questionnaire
Complete a short health questionnaire. Takes about 3 minutes. No appointment needed.
3
Provider Review
A licensed provider reviews your information and approves your prescription within 24-48 hours.
4
Shipped
Your gel is compounded specifically for you at an FDA-registered US pharmacy and shipped directly to your door.

Most orders arrive within 5-7 business days. If your provider determines Ketro RX isn't right for you, you pay nothing.

Why Topical, Not Oral?
When you take ibuprofen for a sore knee, the medication travels through your stomach, into your bloodstream, and disperses across your entire body. All to reach one spot.
Ketro RX
Topical Delivery
Prescription-strength ketorolac applied directly to the site of pain. Same class of medication as ibuprofen. Targeted delivery instead of systemic.
  • Direct to the site of pain
  • No GI side effects
  • Prescription-strength
  • Fast-absorbing, no residue
Oral NSAIDs
Systemic Pathway
Ibuprofen floods your entire system to reach one spot. Passes through your stomach, liver, and bloodstream before reaching the target.
  • Floods entire system
  • Significant GI risk (ulcers, bleeding)
  • Standard OTC dose only
  • Pill format, no targeting
Person holding their neck
The Science
How RX Targets Pain
Prescription-strength ketorolac goes where it's needed. Not through your gut. Not through your bloodstream. Directly through your skin to the site of pain.
Apply
Apply a thin layer directly to the site of pain 3-4 times daily as needed. Lightweight gel absorbs quickly with no greasy residue.
Absorb
Prescription-strength ketorolac passes through the skin to the underlying tissue. No systemic processing. No waiting for digestion.
Target
Active NSAID reaches inflammation directly at the source. No pills. No GI pathway. Targeted, not systemic.
RX is prescription-strength pain relief without the pills
Ketro RX OTC Oral NSAIDs OTC Topicals
Prescription-strength
Direct penetration to pain site
No GI side effects
Clean formula, no residue
Compounded specifically for you
Pro-athlete formulation
Person rubbing their knee
Verified Customer Reviews
★★★★★
Done with daily ibuprofen
“I've had TMJ for years and was tired of taking ibuprofen every day. My dentist suggested a topical NSAID and I found Ketro. I apply it along my jawline and it works without the stomach issues I was getting from daily ibuprofen.”
Rebecca Landry • Verified Buyer • 2/28/26
★★★★★
Goes right on the spot
“Tweaked my shoulder during a tournament and didn't want to keep popping Advil for weeks. RX Pain Gel goes right on the spot. No smell, absorbs fast, and I don't have to worry about what it's doing to my stomach.”
David Moreno • Verified Buyer • 1/15/26
★★★★★
Same class of medication, no oral route
“My doctor told me to stop taking NSAIDs daily because of the GI risks. This gives me the same class of medication without the oral route. The prescription process was easy. Questionnaire took a few minutes.”
Karen Whitfield • Verified Buyer • 3/05/26
★★★★★
Finally something for my knees
“Arthritis in both knees. I was alternating ice packs and Voltaren with minimal results. RX Pain Gel absorbs fast, doesn't feel greasy, and the prescription-strength formula is noticeably different from anything OTC I've tried.”
James Hadley • Verified Buyer • 2/10/26
★★★★★
Wish I had this years ago
“Chronic neck and upper back tension from desk work. I used to take Advil multiple times a week and it was messing with my stomach. Now I just apply this directly to the spot. The provider review was quick and painless.”
Lisa Cheng • Verified Buyer • 1/22/26
What's Inside
Three ingredients. Compounded specifically for you at an FDA-registered US pharmacy. Nothing unnecessary.
Ketorolac 0.5%
The active ingredient. A prescription-strength NSAID that targets inflammation directly at the source when applied topically. The same class of medication as ibuprofen, without the oral route.
Olive Oil
A natural carrier that supports smooth transdermal absorption. Nourishes the skin while delivering the active ingredient where it's needed. Clean, simple, effective.
Topical Gel Base
Lightweight, fast-absorbing gel engineered for rapid delivery through the skin. No greasy residue, no strong medicinal smell. Formulated like skincare.

Every jar is compounded specifically for you at an FDA-registered US compounding pharmacy by Precision Compounding Pharmacy. Never mass-produced. Never sitting on a shelf.

Why Ketorolac?
Ketorolac is one of the most studied NSAIDs in clinical medicine. Here's what the peer-reviewed research shows about topical delivery.
Topical ketorolac gel was significantly more effective than placebo in reducing pain and swelling in a double-blind controlled trial of acute ankle sprains.

Diebschlag W, Nocker W. "A Double-Blind Study of the Efficacy of Topical Ketorolac Tromethamine Gel in the Treatment of Ankle Sprain." The Journal of Clinical Pharmacology, 1990. PubMed 2105985

Topical NSAIDs demonstrate similar efficacy to oral NSAIDs for both acute and chronic pain, with significantly fewer gastrointestinal adverse events. GI toxicity with topical NSAIDs was comparable to placebo.

Klinge SA, Sawyer GA. "Effectiveness and Safety of Topical Versus Oral Nonsteroidal Anti-Inflammatory Drugs: A Comprehensive Review." The Physician and Sportsmedicine, 2013. PubMed 23703519

A systematic review and meta-analysis confirmed that topical NSAIDs carry no increased risk of GI adverse events compared to placebo, while oral NSAIDs significantly increase GI risk.

Honvo G et al. "Safety of Topical Non-steroidal Anti-Inflammatory Drugs in Osteoarthritis: Outcomes of a Systematic Review and Meta-Analysis." Drugs & Aging, 2019. PMC 6509095

Oral ketorolac use beyond 5 days more than doubled the risk of GI bleeding (OR 2.20), with higher doses and older patients at greatest risk. Topical formulations bypass this pathway entirely.

Strom BL et al. "Parenteral Ketorolac and Risk of Gastrointestinal and Operative Site Bleeding: A Postmarketing Surveillance Study." JAMA, 1996. PubMed 8569017

Topical ketorolac delivery via transdermal gel achieved effective local tissue concentrations while maintaining minimal systemic absorption, supporting targeted pain relief without systemic side effects.

Nair B et al. "Topical Delivery of Ketorolac Tromethamine via Cataplasm for Inflammatory Pain Therapy." Pharmaceutics, 2023. PubMed 37242647

All citations are from peer-reviewed, indexed medical journals. Ketro RX is a compounded topical ketorolac formulation. Individual results may vary.
The Ketro Story
Originally Formulated for the Boston Red Sox

The Boston Red Sox training staff needed a topical pain relief formula their players could use before and during games — something prescription-strength that wouldn't require popping pills, wouldn't cause GI issues, and would absorb fast enough to apply between innings. So they asked a compounding pharmacy to build one. The result was a ketorolac-based topical gel with olive oil as the carrier, designed for rapid absorption and clean application. Players used it on shoulders, knees, elbows, and anywhere they needed targeted relief — no oral medication, no systemic side effects, no downtime.

That formula is Ketro RX. Still compounded specifically for you at an FDA-registered US pharmacy. Still the same three ingredients. Now available to everyone through a simple online prescription process.

Common Questions
Do I need a prescription?

Yes. After checkout, you'll complete a short online health questionnaire. A licensed provider reviews your information and approves your prescription. The entire process happens online. No office visit needed.

What if the provider says no?

If your provider determines this isn't right for you, you pay nothing. Full refund, no questions asked.

How is this different from ibuprofen?

Ibuprofen is an oral NSAID that passes through your entire digestive system. Ketro RX is applied directly to the site of pain. Same class of medication, targeted delivery, no GI side effects.

Is Ketro RX stronger than OTC Voltaren?

OTC Voltaren is 1% diclofenac sodium. Ketro RX is 0.5% ketorolac, a different NSAID in the same class. It's prescription-only because of its strength. Customers who've tried both typically report longer time between applications.

How is ketorolac different from diclofenac?

Both are NSAIDs applied topically. Diclofenac has been available OTC since 2020 and is widely prescribed for mild-to-moderate joint pain. Ketorolac is used in IV and IM form for post-surgical pain in hospitals, and compounded topically when a stronger NSAID is warranted. Peer-reviewed studies show topical ketorolac outperforms placebo for acute inflammation.

What conditions is RX used for?

Ketro RX is designed for localized pain where you want prescription-strength relief applied directly to the area instead of taking oral medication. Common use cases include:

TMJ and jaw pain — applied along the jawline and temple area for temporomandibular joint discomfort, jaw clenching, and teeth grinding tension.

Arthritis (knee, hip, hand, wrist) — for osteoarthritis and inflammatory joint pain where oral NSAIDs carry GI risk, especially with long-term daily use.

Neck and upper back pain — desk tension, cervical stiffness, and upper trapezius tightness from long hours at a computer or phone.

Shoulder injuries — rotator cuff strains, frozen shoulder, and overuse injuries from sports or repetitive motion.

Lower back pain — localized lumbar pain, muscle spasms, and post-exertion soreness.

Tennis elbow and golfer's elbow — lateral and medial epicondylitis from racquet sports, golf, weightlifting, or repetitive gripping.

Knee pain — runner's knee, patellofemoral pain, post-surgical recovery, and general knee inflammation.

Plantar fasciitis and foot pain — heel pain, arch inflammation, and Achilles tendon discomfort.

Sports injuries — sprains, strains, and acute muscle injuries from training, competition, or weekend athletics. Originally formulated for professional baseball players.

Tension headaches — applied to the temples, forehead, and base of the skull for headache and migraine-associated tension.

Chronic localized pain — ongoing pain in a specific area where daily oral NSAID use is not advisable due to GI, kidney, or cardiovascular risk.

Post-surgical pain — localized pain management after orthopedic procedures, dental surgery, or other surgical recovery where targeted relief is preferred.

Carpal tunnel and wrist pain — repetitive strain from typing, gaming, or manual work.

Hip pain — bursitis, labral discomfort, and hip flexor tightness.

Fibromyalgia — localized flare-ups, tender points, and widespread musculoskeletal pain. Topical application allows you to target specific flare areas without adding another oral medication to your regimen.

Ehlers-Danlos Syndrome (EDS) — joint hypermobility pain, subluxation soreness, and chronic joint instability. Many EDS patients already take multiple oral medications and prefer topical options to reduce systemic load.

Mast Cell Activation Syndrome (MCAS) — for MCAS patients who experience musculoskeletal pain but need to be careful about oral medications and GI triggers, topical delivery bypasses the digestive system entirely.

Endometriosis-related pain — pelvic and lower abdominal muscle tension, lower back pain associated with endo flares, and post-surgical recovery.

POTS and dysautonomia — joint pain, muscle aches, and exercise recovery for patients managing autonomic dysfunction who want to minimize oral medication interactions.

Autoimmune joint pain — localized flares from rheumatoid arthritis, psoriatic arthritis, lupus, and other autoimmune conditions where adding another oral NSAID isn't ideal.

Neuropathy-adjacent pain — musculoskeletal pain that co-occurs with peripheral neuropathy, where oral NSAIDs may interact with existing medications.

Migraine and cluster headache tension — applied to the neck, temples, and base of the skull for the muscular tension component of migraine and cluster episodes.

Your provider will review your specific condition during the questionnaire process and determine if Ketro RX is appropriate for you.

Can I use Ketro RX for TMJ and jaw pain?

Yes. TMJ is one of the most common use cases for Ketro RX. The gel is applied along the jawline, in front of the ear, and along the temple. Because it's topical, the ketorolac reaches the temporomandibular joint area directly without passing through your digestive system. Many people with TMJ take oral NSAIDs daily, which carries significant GI risk over time. Topical delivery avoids that entirely.

Is Ketro RX good for arthritis?

Ketro RX is commonly used for osteoarthritis pain in the knees, hands, wrists, and hips. For people who need daily NSAID relief but want to avoid the gastrointestinal risks of long-term oral use, a topical prescription-strength formulation allows targeted application directly to the affected joint. Peer-reviewed research shows topical NSAIDs achieve similar efficacy to oral NSAIDs with GI side effects comparable to placebo.

Does this work for deep joint pain, not just surface inflammation?

Topical NSAIDs penetrate through skin into the joint capsule and periarticular tissue. Research shows ketorolac reaches meaningful concentrations at depth when applied over the joint. It works best where the pain source is within ~4cm of the skin: knee, hand, elbow, ankle, jaw. For deeper joints like the hip, many customers still use it, but individual results vary more and pairing with oral medication or physical therapy may be needed.

Can athletes use Ketro RX?

Ketro RX was originally formulated for the Boston Red Sox training staff. Players used it on shoulders, knees, elbows, and other areas before and during games. It absorbs quickly, leaves no residue, and doesn't interfere with grip or mobility. It's used by athletes for acute injuries, post-training soreness, and chronic overuse conditions like tennis elbow and runner's knee.

How long does one jar last?

One 100mL jar of Ketro RX typically lasts up to 6 months with regular use. Apply a thin layer 3-4 times daily as needed. Because a small amount goes a long way with this formulation, most people find it lasts significantly longer than expected.

I have fibromyalgia. Can I use Ketro RX?

Many people with fibromyalgia use Ketro RX for localized flare-ups and tender points. Fibro pain often shows up in specific areas (shoulders, neck, hips, lower back), and topical application lets you target those spots directly. Because it bypasses the digestive system, it doesn't add to the GI burden that many fibro patients already manage with other medications. Your provider will evaluate whether Ketro RX is appropriate based on your full health profile.

Is Ketro RX safe for people with EDS or hypermobility?

Ketro RX is commonly used by people with Ehlers-Danlos Syndrome and joint hypermobility for subluxation soreness, chronic joint pain, and the daily wear that comes with unstable joints. Many EDS patients prefer topical pain relief because they're already managing a complex medication regimen and want to reduce systemic load. Topical ketorolac delivers prescription-strength relief to the specific joint without oral side effects. Discuss with your provider during the questionnaire.

I have MCAS. Will this trigger a reaction?

Because Ketro RX is applied topically and does not pass through the gastrointestinal system, it avoids many of the oral medication triggers that MCAS patients are concerned about. That said, everyone's mast cell triggers are different. We recommend discussing your specific MCAS profile with the provider during the questionnaire process. If your provider determines it's not appropriate for you, you pay nothing.

I'm already on multiple medications. Can I still use this?

One of the advantages of topical delivery is minimal systemic absorption, which means fewer drug interactions compared to oral NSAIDs. This is especially relevant for people managing chronic conditions who are already on several medications. Your provider will review your current medications during the questionnaire and determine if Ketro RX is a safe addition to your regimen.

Is the doctor consultation free?

Yes. The provider review is included in your order. Never a separate charge.

What's the subscription and can I cancel?

Subscribe & Save ships monthly at $116/mo (14% off the one-time price). Cancel, pause, or adjust frequency anytime. No commitments.

Where is RX compounded?

Compounded per order by Precision Compounding Pharmacy, an FDA-registered, licensed US compounding facility. Every batch is made to order. Your gel is compounded specifically for you. Never mass-produced, never sitting on a shelf.

For Daily Tension & Recovery
Ketro CALM Magnesium Cream
Ketro CALM Magnesium Cream
Premium topical magnesium for sore muscles, tight shoulders, and daily tension. Skincare-formulated. Lightweight, fast-absorbing, no residue. Pair with RX for daily muscle maintenance.
$35/mo
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RX: Pain Gel $116/mo Save 14%
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