Parenteral and rectal paracetamol and NSAID drug regimens for acute nociceptive pain in adults

If intravenous paracetamol is required for acute nociceptive pain in adults, use:

paracetamol 1 g intravenously, 6-hourly if required. Maximum 4 g in 24 hours. acute pain, intravenous dosing (adults) paracetamol

If rectal paracetamol is required for acute nociceptive pain in adults, use:

paracetamol 1 g rectally, 6-hourly if required. Maximum 4 g in 24 hours. acute pain, rectal dosing (adults) paracetamol

If a parenteral NSAID is required for acute nociceptive pain in adults, use:

1 ibuprofen 400 to 800 mg as an intravenous infusion as a single dose acute pain, intravenous dosing (adults) ibuprofen

1 parecoxib 40 mg intravenously or intramuscularly as a single dose. acute pain, parenteral dosing (adults) parecoxib

If repeat doses of a parenteral NSAID are required, refer to local protocols or seek expert advice.

If a rectal NSAID is required for acute nociceptive pain in adults, use:

diclofenac 25 to 50 mg rectally, 8-hourly if required. acute pain, rectal dosing (adults) diclofenac

Indometacin can be used as an alternative to rectal diclofenac in adults. Smaller doses of rectal indometacin are required in older adults, but should be avoided because lower dose rectal formulations are not available. If rectal indometacin is indicated for acute nociceptive pain in adults, use:

indometacin 100 mg rectally, once or twice daily if required. acute pain indometacin