Table 1.
Most commonly used nonopioid analgesics in United States
| Drug | Preparation | Dose | Maximum | Comments |
|---|---|---|---|---|
| Acetaminophen | tablets – 325, 500, 650 mg suspension – 160, 325 mg/5 ml suppository – 80, 120, 125, 200, 300, 325, 600, 650 mg |
325–1000 mg PO q4–6h PRN |
4000 mg/day | No anti-inflammatory effect. Hepatotoxic if overdosed |
| Aspirin | tablets – 81, 162, 325, 500, 650, 975 mg suppository – 60, 120, 200, 300, 600 mg |
325–650 mg PO q4h PRN |
4000 mg/day | Bleeding risk is the most significant concern |
| Diclofenac | tablets – 50 mg delayed-release – 25, 50, 75, 100 mg SR |
50 mg PO BID-TID |
150 mg/day | Alt dose for SR form is 100 mg PO daily |
| Etodolac | tablets – 400, 500 mg extended-release – 400, 500, 600 mg SR capsules – 200, 300 mg |
200–400 mg PO q6–8h |
1200 mg/day | The dose for SR is 400–1000 mg once daily |
| Ibuprofen | tablets – 100, 200, 400, 600, 800 mg suspension – 40 mg/ml, 100 mg/5 ml |
400–600 mg PO q4–6h PRN |
3200 mg/day | Use with caution in patients with history of peptic ulcer |
| Indomethacin | capsules – 25, 50 mg extended-release – 75 mg SR suspension – 25 mg/5 ml suppository – 50 mg |
25–50 mg PO TID |
200 mg/day | Use with caution in patients with history of peptic ulcer |
| Ketoprofen | tablets – 12.5 mg capsules – 25, 50, 75 mg extended-release – 100, 150, 200 mg SR |
25–50 mg PO q6h–q8h |
300 mg/day | Maximum dose for SR form is 200 mg/day |
| Ketorolac | tablets – 10 mg parenteral – 15 mg/ml, 30 mg/ml |
10 mg PO q4–6h PRN or 30 mg IV/IM q6h |
40 mg/day PO or 120 mg/day IV/IM |
IV therapy should not exceed 5 days |
| Meclofenamate | capsules – 50, 100 mg | 50–100 mg PO q4–6h PRN |
400 mg/day | |
| Mefenamic acid | capsules – 250 mg | 250 mg PO q4–6 PRN |
For therapy ≤ 1 wk in duration |
Recommended first dose is 500 mg PO |
| Meloxicam | tablets – 7.5, 15 mg suspension – 7.5 mg/5 mL |
7.5–15 mg PO once daily |
15 mg/day | COX-2 preferential NSAID |
| Nabumetone | tablets – 500, 750 mg 2000 mg/day |
100–2000 mg once daily | May divide daily dose to BID | |
| Naproxen | tablets – 250, 375, 500 mg SR – 375, 500 mg suspension – 125 mg/5 ml |
250–500 mg PO BID | 1500 mg/day for 3–5days |
Maintenance dose is maximum 1000 mg/d for 6 months |
| Oxaprozin | tablets – 600mg | 1200 mg PO once daily |
1800 mg/day | |
| Piroxicam | capsules – 10, 20 mg | 20 mg PO once daily |
20 mg/day | May divide daily dose BID |
| Sulindac | tablets – 150, 200 mg | 150–200 mg PO BID | 400 mg/day | |
| Tolmetin | capsules – 400 mg tablets – 200, 600 mg |
200–600 mg PO BID-TID |
1800 mg/day | |
| Tramadol | Tablets – 50 mg extended-release – 100, 200, 300 mg SR |
50–100 mg PO q4–6h PRN; 100– 300 mg QD for SR |
400 mg/day | Maximum dose for SR form is 300 mg/day |
| Celecoxib | capsules – 100, 200, 400 mg | 200 mg PO BID | 400 mg/day | COX-2 inhibitor |
| Rofecoxib* | tablets – 12.5, 25, 50 mg suspension – 12.5 mg/5 ml, |
50 mg PO daily for 5 days, then 25 mg PO 25 mg/5 ml daily |
Withdrawn from the market in 2004 | |
| Valdecoxib* | tablets – 10, 20 mg | 10-20 mg PO BID | Withdrawn from the market in 2005 | |
Abbreviations: PO, oral; IM, intramuscular; IV, intravenous; PRN, as needed; BID, twice daily; TID, three times daily; NSAID, nonsteroidal anti-inflammatory drug; SR, sustained release.
*
Note: COX-2 inhibitors Rofecoxib (Vioxx) and Valdecoxib (Bextra) were removed from the market due to increased cardiovascular and dermatological risks.