Non-opioid analgesics (Formulary)

Important: Formulation and dosage details

Formulation:

Tablets^OTC 500mg

• Paracetamol caplets may be easier to swallow than standard tablets and are preferred by many patients. Caplets may be supplied on a prescription for paracetamol tablets.

Dosage:

As per BNF.

Important: Formulation and dosage details

Formulation:

Soluble tablets^OTC 500mg

• The salt content of dispersible formulations of paracetamol and co-codamol may be unsuitable for some patients.

Dosage:

As per BNF.

Important: Formulation and dosage details

Formulation:

Oral suspension^OTC 120mg/5mL, 250mg/5mL

Dosage:

As per BNF.

Important: Formulation and dosage details

Formulation:

Suppositories^OTC 60mg, 120mg, 240mg, 500mg

Dosage:

As per BNF.

Important: Formulation and dosage details

Formulation:

Intravenous infusion 500mg/50mL, 1 gram/100mL

Dosage:

As per BNF.
Consider dose reduction in patients with low body weight (less than 51kg), renal/hepatic impairment, chronic malnutrition, or chronic alcoholism.

Notes:

Paracetamol infusion:

MHRA advice: Intravenous paracetamol (Perfalgan▼): risk of accidental overdose (December 2014) 

• Is 100% bioavailable and there is a greater risk of toxicity so should only be prescribed where clinically indicated. Review the prescription regularly.
• Should only be used when the patient is ‘nil by mouth’, or has swallowing difficulty that is not overcome by the use of suspension.
• Must be given in lower doses to patients under 51kg.
• Renal impairment: increase dose interval as per BNF.
• Hepatic impairment: reduce dose as per BNF.
• Increase the minimum interval between each dose to 6 hours if creatinine clearance is less than 30mL/min.
• Is more effective than paracetamol suppositories.

Important: Formulation and dosage details

Formulation:

Tablets 30mg (specialist initiation/recommendation only)

Dosage:

By mouth, in patients with renal impairment as an alternative to opioids and NSAIDs, start at 30mg up to 3 times daily.