The Stack: RX + CALM
RX Pain Gel is prescription-only. A licensed provider reviews your health questionnaire after checkout. If RX isn't right for you, you pay nothing.
“RX for the flare-ups, CALM every night. Haven't taken an oral painkiller in two months.”
RX ships from Precision Compounding Pharmacy in 5-7 business days after approval. CALM ships separately from Ketro fulfillment. If your provider determines RX isn't right for you, you pay nothing for the RX half.
- RX: prescription-strength for acute flares
- CALM: daily magnesium for muscle tension
- No GI side effects from either
- Fast-absorbing, no greasy residue
- Oral NSAIDs flood the entire system
- GI risk from daily oral NSAID use
- Oral magnesium often causes loose stool
- Neither goes directly to the muscle that hurts
| Ketro Stack | Oral NSAID + Supplement | Drugstore Topicals | |
|---|---|---|---|
| Prescription-strength NSAID for flares | |||
| Direct delivery to the muscle | |||
| No GI side effects | |||
| Daily muscle recovery support | |||
| Fast-absorbing, no residue | |||
| RX compounded specifically for you | |||
| Pro-athlete formulation |
RX is compounded specifically for you at an FDA-registered US compounding pharmacy by Precision Compounding Pharmacy. Never mass-produced. CALM is manufactured by Biocrown and packaged by MYPACK to skincare-grade standards.
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
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
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
Strom BL et al. "Parenteral Ketorolac and Risk of Gastrointestinal and Operative Site Bleeding: A Postmarketing Surveillance Study." JAMA, 1996. PubMed 8569017
Nair B et al. "Topical Delivery of Ketorolac Tromethamine via Cataplasm for Inflammatory Pain Therapy." Pharmaceutics, 2023. PubMed 37242647
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 designed for rapid absorption and clean application. Players used it on shoulders, knees, elbows, and anywhere they needed targeted relief.
That formula is Ketro RX. Still compounded specifically for you at an FDA-registered US pharmacy. Still the same three ingredients.
CALM Magnesium Cream is the daily counterpart Ketro built next — the same topical philosophy applied to magnesium. Where RX is prescription-strength for acute pain, CALM is skincare-formulated for daily tension and recovery. Together, they cover both ends of the spectrum.
Start the Stack by beginning the RX intake. Complete a short health questionnaire. A licensed provider reviews and approves your prescription. Once approved, your Stack subscription includes both products — RX ships from Precision Compounding Pharmacy, CALM ships from Ketro fulfillment. Both auto-deliver monthly.
RX is prescription-strength ketorolac, applied when acute pain flares. CALM is daily transdermal magnesium, applied to support muscle recovery between flares. Using both means you're not waiting for pain to flare before doing something about it — you're also supporting the muscle with daily magnesium to reduce the tension that leads to pain in the first place.
Subscribe & Save is $151/mo for the full Stack — RX Pain Gel + CALM Magnesium Cream delivered monthly. One-time purchase is $200. Subscription saves 24% and includes free shipping (orders over $75).
They arrive separately. CALM ships from Ketro fulfillment. RX is compounded per order and ships from Precision Compounding Pharmacy once your provider approves your prescription. Both bill through the same checkout.
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.
If your provider determines RX isn't right for you during the questionnaire, you pay nothing — you're only charged once the prescription is approved.
CALM (60-day money-back on first order). If CALM isn't working for you, email customerservice@ketroskin.com within 60 days of delivery on your first order and we'll refund you. No need to return the product. Subscription refills are non-refundable, but you can pause or cancel anytime.
RX — cancel before we compound. Because RX Pain Gel is compounded specifically for you at Precision Compounding Pharmacy, we can't accept returns once it's been made. Email customerservice@ketroskin.com immediately if you need to cancel — we may be able to stop the order before compounding begins.
RX damage / defect / wrong item. Per pharmacy regulations, you have 7 days from delivery to report any damage, defect, or incorrect item with your RX. Email us with your order number and a photo and we'll send a replacement or full refund.
The Stack is designed for people managing ongoing musculoskeletal pain who want both prescription-strength acute relief and daily muscle support. Common use cases include:
TMJ and jaw tension — RX along the jawline during flares, CALM daily on the masseter and temple.
Arthritis — RX on the affected joint during flare-ups, CALM daily for surrounding muscle tension.
Neck and upper back tension — desk tension from long hours at a computer. RX for the sharp days, CALM every evening.
Shoulder and rotator cuff — overuse, sports, repetitive motion. RX targeted, CALM for recovery.
Lower back — post-exertion soreness, chronic tightness. RX for acute flares, CALM daily.
Knee pain — runner's knee, arthritis. RX on the joint, CALM on surrounding muscle.
Sports recovery — RX for acute injuries, CALM as part of the daily recovery routine.
Tension headaches — applied to the temples, forehead, and base of the skull.
Restless legs and nighttime cramping — CALM massaged into the calves before bed; RX if there's an underlying joint pain component.
Your provider will review your specific condition during the RX questionnaire.
Yes. TMJ is one of the most common use cases. Apply RX along the jawline, in front of the ear, and along the temple during flare-ups — because it's topical, the ketorolac reaches the temporomandibular joint area directly. Use CALM daily on the same area to ease the background muscle tension that drives clenching and grinding.
RX is commonly used for osteoarthritis pain in the knees, hands, wrists, and hips — a prescription-strength topical alternative to daily oral NSAIDs. CALM supports the surrounding muscle tension that often accompanies joint pain. Together they let you manage both the inflammation at the joint and the compensation pain in the muscles around it.
RX was originally formulated for the Boston Red Sox training staff — used before and during games. CALM fits cleanly into a daily recovery routine. Together they cover both acute injury (RX) and ongoing training-load muscle maintenance (CALM). Absorbs quickly, no residue, doesn't interfere with grip or mobility.
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 RX questionnaire.
Yes. The provider review is included in your order. Never a separate charge.
Compounded per order by Precision Compounding Pharmacy, an FDA-registered, licensed US compounding facility. Every batch is made to order. Never mass-produced, never sitting on a shelf.