Table 9. Dosing data for acetaminophen (APAP) and NSAIDs

Drug Usual dose for adults
and children
> 50 kg body weight		 Usual dose for children[1]
and adults[2]
< 50 kg body weight
Acetaminophen and over-the-counter NSAIDs
Acetaminophen[3] 650 mg q 4 h
975 mg q 6 h		 10-15 mg/kg q 4 h
15-20 mg/kg q 4 h (rectal)
Aspirin[4] 650 mg q 4 h
975 mg q 6 h		 10-15 mg/kg q 4 h
15-20 mg/kg q 4 h (rectal)
Ibuprofen (Motrin, others) 400-600 mg q 6 h 10 mg/kg q 6-8 h5 [5]
Prescription NSAIDs
Carprofen (Rimadyl) 100 mg tid
Choline magnesium trisalicylate[6](Trilisate) 1,000-1,500 mg tid 25 mg/kg tid
Choline salicylate (Arthropan)[6] 870 mg q 3-4 h
Diflunisal (Dolobid)[7] 500 mg q 12 h
Etodolac (Lodine) 200-400 mg q 6-8 h
Fenoprofen calcium (Nalfon) 300-600 mg q 6 h
Ketoprofen (Orudis) 25-60 mg q 6-8 h
Ketorolac tromethamine[8] (Toradol) 10 mg q 4-6 h to a maximum of 40 mg/day
Magnesium salicylate (Doan's, Magan, Mobidin, others) 650 mg q 4 h
Meclofenamate sodium (Meclomen)[9] 50-100 mg q 6 h
Mefenamic acid (Ponstel) 250 mg q 6 h
Naproxen (Naprosyn) 250-275 mg q 6-8 h 5 mg/kg q 8 h
Naproxen sodium (Anaprox) 275 mg q 6-8 h
Sodium salicylate (Generic) 325-650 mg q 3-4 h
Parenteral NSAIDs
Ketorolac tromethamine[8,10] (Toradol) 60 mg initially, then 30 mg q 6 h Intramuscular dose not to exceed 5 days

[1] Only drugs that are FDA approved as an analgesic for use in children are included.
[2] Acetaminophen and NSAID dosages for adults weighing less than 50 kg should be adjusted for weight.
[3] antiplatelet activities of the other NSAIDs.
[4] The standard against which other NSAIDs are compared. May inhibit platelet aggregation for >e; 1 week and may cause bleeding. Aspirin is contraindicated in children with fever or other viral disease because of its association with Reye's syndrome.
[5] Not FDA approved for use in children as an over-the-counter drug; has FDA approval for us in children as a prescription drug for fever. However, clinicians have experience in prescribing ibuprofen for pain in children.
[6] May have minimal antiplatelet activity.
[7] Administration with antacids may decrease absorption.
[8] For short-term use only.
[9] Coombs-positive autoimmune hemolytic anemia has been associated with prolonged use.
[10] Has the same GI toxicities as oral NSAIDs.

Note: Only the above NSAIDs have FDA approval for use as simple analgesics, but clinical experience has been gained with other drugs as well.

Related Chunks

Nonsteroidal Anti-inflammatory drugs (NSAIDs)

Transdermal

Figure 2: The WHO Ladder

Dose Equivalence Table for Opioid Analgesics in Opioid-naive Adults and Children greater than or equal to 50kg body weight.

Dose Equivalence Table for Opioid Analgesics in Opioid-naive Adults and Children less than 50kg body weight.

Figure 5: Pain Management Plan

Medical Interventions

Analgesics for Neonates and Young Infants

Index