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Pain (PDQ®)

  • Updated: 05/03/2013

Table 1. Dosing Recommendations for Acetaminophen and Anti-inflammatoriesa

Drug Usual Dose for Adults and Children ≥50 kg Body Weight Usual Dose for Adults and Childrenb <50 kg Body Weight 
Enteral Medications
acetaminophenc50 mg q4h; max dose is 400 mg in 24 h (PO)10–15 mg/kg q4h; max dose is 75 mg/kg total in 24 h (PO)
975 mg q6h; max dose is 4,000 mg in 24 h (PO)
aspirind650 mg q4h (PO)10–15 mg/kg q4h (PO)
975 mg q6h (PO)15–20 mg/kg q4h (PR)
ibuprofen (Motrin, Advil)400–600 mg q6h (PO)5–10 mg/kg q4–6h (PO)
magnesium salicylate (Doan’s, Magan, Mobidin, others)650 mg q4h (PO)
naproxen (Naprosyn, Aleve)250–275 mg q6–8h (PO)5 mg/kg q8h (PO)
naproxen sodium (Anaprox)275 mg q6–8h (PO)
carprofen (Rimadyl)100 mg tid (PO)
choline magnesium trisalicylatee (Trilisate)1,000–1,500 mg q6–8h (PO)25 mg/kg q6–8h (PO)
choline salicylatee (Arthropan)870 mg q3–4h (PO)
diclofenac (oral) (Voltaren - 1% topical; Pennsaid - 1.5% topical)50 mg bid–tid oral; 32 g/d topicalFlector (patch): 1 patch bid
diflunisalf (Dolobid)500 mg q12h (PO)
etodolac (Lodine)200–400 mg q6–8h (PO)
fenoprofen calcium (Nalfon)300–600 mg q6h (PO)
ketoprofen (Orudis)25–60 mg q6–8h (PO)
ketorolac tromethamineg (Toradol)10 mg q4–6h to a maximum of 40 mg/d
IV administration should not exceed 5 days
meclofenamate sodiumh (Meclomen)50–100 mg q6h (PO)
mefenamic acid (Ponstel)250 mg q6h (PO)
sodium salicylate (Anacin, Bufferin)325–650 mg q3–4h (PO)
Parenteral Medications
acetaminophen (rectal)650 mg q4–6h, total 3,900 mg (adults aged >12 y) (PR)15–20 mg/kg q4h (PR), max dose 75 mg/kg total in 24 h
IV acetaminophen1,000 mg q6h (IV) (adults)15 mg/kg max (IV), 75 mg/kg in 24 h (children aged <13 y)
ketorolac tromethamineg,i (Toradol)60 mg initially, then 30 mg q6h (IV)
IV administration should not exceed 5 days

bid = twice a day; IV = intravenous; PO = by mouth; PR = by rectum; q = every; tid = 3 times a day.
aOnly the nonsteroidal anti-inflammatory drugs (NSAIDs) listed here have FDA approval for use as simple analgesics, but clinical experience has also been gained with other drugs.
bAcetaminophen and NSAID dosages for adults weighing less than 50 kg should be adjusted for weight.
cAcetaminophen lacks the peripheral anti-inflammatory and antiplatelet activities of the other NSAIDs.
dThe standard against which other NSAIDs are compared. May inhibit platelet aggregation for longer than 1 week and may cause bleeding. Aspirin is not recommended for pain in children.
eMay have minimal antiplatelet activity.
fAdministration with antacids may decrease absorption.
gUse limited to 5 days or fewer.
hCoombs-positive autoimmune hemolytic anemia has been associated with prolonged use.
iHas the same gastrointestinal toxic effects as oral NSAIDs.