Adult Analgesia - Mild
| Drug | Dosage | Frequency | Route |
|---|---|---|---|
| Paracetamol★ (IV Route 15mg/kg if <50kg) ★ Exercise caution with IV paracetamol (particularly in malnutrition/alcohol) | 1 g | QDS | PO / PR / IV |
| Ibuprofen (2.4g/24hrs) - Check renal function and Hb | 200-400 mg | TDS | PO |
| Sopladeine/Maxilief (Paracetamol 500mg, 8mg Codeine per tab) | 2 tabs | TDS/QDS | PO |
| Solpadol (Paracetamol 500mg, 30mg Codeine) | 2 tabs | TDS/QDS | PO |
| Buscopan (esp crampy abdo pain) | 10-20 mg | TDS/QDS | PO / IV / IM |
Consider higher doses of short acting opoids for severe pain or younger / larger
Adult Analgesia - Moderate
| Drug | Dosage | Frequency | Route |
|---|---|---|---|
| Diclofenac (Not if ↑ Creat) | 75 mg | BD | PO |
| Diclofenac Suppository | 100 mg | 18 hrs | PR |
| Naproxen (Not if ↑ Creat) | 250-500 mg | BD | PO |
| Etoricoxib (Not if ↑ Creat) | 30-90 mg | OD | PO |
| Mefanamic Acid (Ponstan, can ↑ Creat) | 250-500 mg | TDS | PO |
| Tramadol (400mg/24hrs) 300mg = 30mg morphine sc - 60mg | 50-100 mg | QDS | PO / IM |
Consider higher doses of short acting opoids for severe pain or younger / larger
Adult Analgesia - Severe
| Drug | Dosage for Elderly, GFR or “Tiny” | Dosage for Otherwise | Frequency | Route |
|---|---|---|---|---|
| Oramorph (short acting) | 2.5-5 mg | 5-10 mg | 4hr PRN | PO |
| MST (sustained release) | 5mg (Titr) | 10 mg (Titr) | BD | PO |
| Morphine Sulfate★ | 2.5-5 mg | 5-10 mg | PRN | SC |
| Oxycontin★★ | 5mg (Titr) | 10 mg (Titr) | BD | PO |
| Oxynorm (immediate release) | 2.5mg (Max 6 hourly in mild to moderate renal impairment. Avoid in Severe) | 5-10 mg | 4-6 hr PRN | PO |
| Pregabalin (use short duration only if possible) | 25 mg | 50 mg | BD/Titr | PO |
| Palexia SR (Tapentadol Modified release) | 50 mg (Avoid in severe renal impairment) | 50 mg | BD | PO |
| Palexia (immediate release) | 50 mg (Avoid in severe renal impairment) | 50 mg | 4-6 hr | PO |
| Targin (Oxycodone/naloxone) Counteracts opoid-induced constipation | 5/2.5mg | 10/5mg (Titr) | BD | PO |
| Chronic Stable Pain Consider Buprenorphine patch (Equivalent to 10mg morphine/24hrs) | 5mcg/hour Topically | Change patch weekly | ||