Last Jan 25th, I joined a course on how to manage pain and what really interest me is the analgesics.
Just want to share with you all.
All the medications used to treat pain are as below:
| DRUG | FORMULATION AVAILABLE | DOSAGE |
| Paracetamol | Tablet 500mg,Suspension 500mg/5ml,
Suppositories |
500 mg – 1gm qid |
| NSAID | ||
| Diclofenac | Tablet 50mg & 25mg,Suppositories 12.5mg, 25mg, (50mg & 100mg)*
Gel |
Oral: 50mg tds,Sup: 50mg-100mg stat
Topical: PRN |
| Mefenamic Acid (Ponstan) | Capsule 250mg | 250 mg – 500mg tds |
| Ibuprofen ( Brufen) | Tablet 200mg & 400mg* | 200 mg – 400 mg tds |
| Naproxen (Naprosyn, Synflex) | Tablet 250mg, 550mg | 500mg-550 mg bd |
| Ketoprofen (Orudis, Oruvail) | Capsule 100mg *, Injection 100mg,Patch 30mg, Gel | Oral: 100mg daily, IV: 100mg bdPatch: 30mg – 60mg bd, Topical: PRN |
| Ketorolac (Toradol) | Injection 30mg/ml | 10mg – 20 mg bd max 3 days |
| Meloxicam ( Mobic) | Tab 7.5mg | Daily or bd |
| COX 2 inhibitors | ||
| Celecoxib | Capsule 200 mg | 200 mg bd (max 1 week) |
| Etoricoxib | Tablet 90 mg & 120 mg | 120 mg daily (max 1 week) |
| Parecoxib | Injection 20 mg/ml | 40 mg bd ( 20 mg bd for elderly) max for 2 days |
| WEAK OPIOID | ||
| Tramadol | Capsule 50mg, Injection 50mg/ml | 50mg -100mg tds or qid (max 400mg/day) |
| Dihydrocodeine (DF118) | Tablet 30 mg | 30mg-60mg qid (max 360mg/day) |
| STRONG OPIOID | ||
| Nalbuphine (Nubain) | Injection 10mg/ml | Stat dose only: 10mg (equivalent to Morphine 10mg). Do not use in patients on regular Morphine/ Pethidine/ Fentanyl. |
| Morphine | Tablet SR 10mg,30mgAqueous 10mg / 5ml
Injection 10 mg/ml, |
SR and Aqueous to be used for cancer painIV and Subcut :
< 65yrs : 5mg -10mg 3-4hrly > 65yrs : 2.5mg -5mg 3-4hrly Reduce dose in renal and hepatic impairment |
| Fentanyl | Injection 50 mcg/ml,Patch 25 mcg, 50 mcg | IV only to be prescribed by APS team.Patch to be used in cancer pain; NOT in Acute Pain |
| Pethidine | Injection 50mg/ml,100mg/2ml | IV and Subcut :< 65yrs : 50mg -100mg 3-4hrly
> 65yrs : 25mg -50mg 3-4hrly Reduce dose in renal and hepatic impairment. Use not encouraged because of Norpethidine toxicity and high risk of addiction. |
| Oxycodone ( Oxycontin) | Tablet SR 10mg & 20mg | Mainly used for cancer pain |
