Non-steroidal anti-inflammatory drugs (NSAIDs) (Formulary)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

MHRA advice: Non-steroidal anti-inflammatory drugs (NSAIDs): potential risks following prolonged use after 20 weeks of pregnancy (June 2023) (www.gov.uk).  

IBUPROFEN - (First line)

Therapy notes

  • For further information regarding COVID-19 see here.
  • Ibuprofen in a dose of 1·2 grams per day or less is first choice.
  • For OTC use the maximum dose is 1·2 grams daily. 
  • All risks increase above 1·2 grams daily.
  • Maintenance dose of 600mg to 1·2 grams daily may be adequate. 

Formulation and dosage details

Formulation:

Tablets 200mgOTC, 400mgOTC, 600mg

Dosage:

Initially 600mg to 1·8 grams daily in 3 to 4 divided doses, preferably after food; higher doses may be necessary in rheumatoid arthritis or gout; maximum of 2·4 grams daily.

Formulation and dosage details

Formulation:

Oral suspension 100mg/5mLOTC

Dosage:

Initially 600mg to 1·8 grams daily in 3 to 4 divided doses, preferably after food; higher doses may be necessary in rheumatoid arthritis or gout; maximum of 2·4 grams daily. 

NAPROXEN - (First line)

Therapy notes

Formulation and dosage details

Formulation:

Tablets 250mgOTC, 500mg

Dosage:

500mg to 1 gram daily in 1 to 2 divided doses.
Acute musculoskeletal disorders: 500mg initially, then 250mg every 6 to 8 hours as required, maximum dose after first day 1 gram daily.
Acute gout: 750mg initially, then 250mg every 8 hours until attack has passed.

Formulation and dosage details

Formulation:

Oral suspension 250mg/5mL

Dosage:

500mg to 1 gram daily in 1 to 2 divided doses.
Acute musculoskeletal disorders: 500mg initially, then 250mg every 6 to 8 hours as required, maximum dose after first day 1 gram daily.
Acute gout: 750mg initially, then 250mg every 8 hours until attack has passed.

CELECOXIB

Therapy notes

Formulation and dosage details

Formulation:

Capsules 100mg, 200mg

Dosage:

Osteoarthritis: 200mg daily in 1 to 2 divided doses, increased if necessary to maximum 200mg twice daily.
Rheumatoid arthritis: 200 to 400mg daily in 2 divided doses; older people, initially 200mg daily in 2 divided doses; maximum 200mg twice daily.

DICLOFENAC

Therapy notes

  • Diclofenac is associated with an increased risk of thrombotic events.

Formulation and dosage details

Formulation:

Enteric coated tablets 25mg, 50mg

Dosage:

Enteric coated by mouth: 75 to 150mg daily in 2 to 3 divided doses, preferably after food.

 

Formulation and dosage details

Formulation:

Modified release tablets 75mg, 100mg

Dosage:

Modified release: 75mg to 150mg daily.

Formulation and dosage details

Formulation:

Suppositories 12·5mg, 25mg, 50mg, 100mg

Dosage:

By rectum: 75 to 150mg daily in divided doses.

Formulation and dosage details

Formulation:

Injection 75mg/3mL

Dosage:

By injection: see Genito-urinary disorders.

Editorial Information

Document Id: F270