Britain's Jack Draper ousted Italian Lorenzo Musetti to set up a Madrid Open title showdown with Norwegian Casper Ruud who overcame a rib issue to book his final ticket.

Ruud squeezed into the 25th tour-level final of his career on Friday with a 6-4, 7-5 victory over Argentine Francisco Cerundolo after a medical timeout because of chest and back discomfort.

Ruud was followed into the final by Draper who battled to a 6-3, 7-6 (7/4) victory over Monte Carlo runner-up Musetti.

"To be back in a Masters 1000 final feels great," said Ruud.

"It's not every day you get to play for these titles. I've been in two finals before and lost both, so hopefully it'll be third time is a charm."

The Norwegian lost both of his two previous Masters 1000 finals – in the 2024 Monte Carlo and 2022 Miami.

"Casper is such an experienced player, someone who has made finals of two Grand Slams, is just a complete pro, and someone who always gives his best and is so tough to beat," said Draper.

Ruud saved a whopping 15 of 18 break points during the one-hour 54-minute clash.

Overcoming early chest discomfort and in the face of a rowdy pro-Argentinian crowd, Ruud was proud of how he handled the adversity.

At the 2-1 changeover, the Norwegian asked for a medical timeout for a sharp pain in his chest and back.

Unnerved by the interruption, Cerundolo took the next two games, breaking Ruud at love to move ahead 3-2 but the Argentine's lead was short-lived as his opponent struck right back.

Ruud upped the pressure in game 10 with a signature inside-out forehand and snatched the set on the 48-minute mark.

The second set was a see-saw affair that witnessed a combined five breaks of serve from 18 break point opportunities.

During a marathon 13-minute game, Ruud saved seven break points to hold for 3-2, but not before he had an argument with the chair umpire, over Argentinian fans disrupting him ahead of his serve.

The pivotal moment came in game 12 as Ruud converted a second match point to reach his first Madrid final.

"I wasn't sure I was going to be able to finish the match, honestly," said the Norwegian.

"My physio took a look at it after and cracked my back up, which felt like a relief. Hopefully it's nothing too serious.

Later on Manolo Santana stadium, Draper improved to 4-0 in career meetings with Musetti and advanced to his second Masters 1000 final of the year.

"I felt like both of us, our quality didn't drop from the first ball. Credit to Lorenzo, he's honestly playing so good on the clay," said Draper, winner on hard court in Indian Wells in March and set to enter the top five next week.

"I've played him on the hard and on the grass in the juniors, growing up with him. But on the clay he's a different beast and so, to get this win, on this court, in this stage, in the semi-finals of this competition, honestly it means so much to me."

The 23-year-old lefty fired 20 winners against 19 unforced errors in a high-quality two-hour showdown with the Italian.(AFP)