200

mg

Tablet

Orally 

every 6 hrs

20

mg

Tablet

orally

3 times a day

40 mg orally twice a day

Immediate release:

25 - 50

mg

Tablet

Orally 

every 8 hrs

Extended release-200mg orally every day

Immediate release Acute:

50 - 100

mg

Tablets

Orally 

every 6 hrs

Do not exceed 400mg/day
Chronic:
Initial dose-25mg orally everyday morning
Maintenance dose-25-50mg/day for every three days
Final dose-50-100mg orally every 4-6 hours.Do not exceed 400mg/day
Extended-release
100mg orally daily once, up to 100mg/day for every five days.Do not exceed 300mg/day
Oral Solution
Initial dose-25mg/day orally ,increase the dosage by 25 mg every three days Do not exceed 400mg/day

Dose Adjustments

Renal impairment
CrCl<30ml/min: No dosage adjustment is needed
CrCl>30ml/min: 50-100mg orally every 12 hour
Hepatic impairment
No dosage adjustment is necessary

Patients tolerant to opioids:

¼ dose of 10-20mg/70 kg SC/IV/IM should be administered every 3-6 hours. Do not exceed 160mg/day
Non-tolerant patients to opioids
10-20mg/70 kg SC/IV/IM should be administered every 3-6 hours when necessary
Do not exceed 20 mg/individual dose

Before opioid exposure
2-4mg orally every 6-8 hours when necessary
1mg intramuscular/subcutaneous every 6-8 hours when necessary
1mg intravenously slowly every 3-6 hours. Do not exceed 4-8mg every 24 hours

Opiate naïve
2mg orally every 6-8 hours when necessary
1mg intramuscular/subcutaneous every 6-8 hours when necessary
1mg intravenously slowly every 3-6 hours. Do not exceed 4-8mg every 24 hours

Premedication
Administer 1-2mg/dose intramuscular/subcutaneous 60-90mins before the surgery

Insect bites, Sunburn,Minor burns
apply 5-20% to the affected area every 6 to 8 hours when necessary

Mouth pain/Sore throat
Dissolve one lozenge in mouth, repeat every 2 hours when necessary

Dental pain
use 2.5-20% solution when necessary

Indicated for Cataract Post-Operative Ocular Pain/Inflammation:

0.07% and 0.09% Ophthalmic Solution: Instil 1 drop to each affected eye once a day prior to 1 day before cataract surgery and through post-operative period of 14 days

0.075% Ophthalmic Solution: Instil 1 drop to each affected eye twice a day before one day before cataract surgery and through a postoperative period of 14 days

Indicated for Moderate to Severe Pain :

1

Tablet

Orally 

every 3-4 hours

or may increase to 2 tablets if required

Do not exceed 12 tablets a day

Dose Adjustments

Renal Impairment CrCl if 10–50 mL/min: 75% of the recommended adult dose CrCl if less than 10 mL/min: 50% of the typical adult dose Hepatic Impairment Use caution

1

Tablet

Orally 

every 4 hrs

Do not exceed 6 tablets per day

Indicated for Moderate to Mild Pain:

Two tablets orally four times a day when necessary
Do not exceed eight tablets in 24 hours

Indicated for neuropathic pain
150 mg sustained-release bupropion orally twice daily for 6 weeks

indicated for acute severe pain
This medication is recommended for the short-term (up to 14 days) management of intense pain that necessitates the use of an opioid analgesic when other treatment options are insufficient
It is advised to administer the lowest effective dose for the shortest duration necessary, considering the specific treatment objectives for each patient
The total dosage of benzhydrocodone/acetaminophen, along with any other products containing acetaminophen, should not exceed 4000 mg of acetaminophen per day
As First Opioid Analgesic
Recommended starting dose: Take 1 or 2 tablets orally every 4 to 6 hours as needed for pain
Each tablet contains acetaminophen in the range of 325 to 650 mg and benzhydrocodone in the range of 6.12 to 12.24 mg
Maximum daily dose: Do not exceed 12 tablets within a 24-hour period
Maximum acetaminophen dose: Ensure that the total acetaminophen intake from all products, including this medication, does not exceed 4000 mg in a 24-hour period
Duration of treatment: It is generally advised to use this medication for a period of 7 to 14 days
Please note that this dosage and duration of therapy should be determined by your healthcare professional
Equivalence to hydrocodone bitartrate
benzhydrocodone containing 4.08 mg is similar to hydrocodone bitartrate 5 mg
benzhydrocodone containing 6.12 mg is similar to hydrocodone bitartrate 7.5 mg
benzhydrocodone containing 8.16 mg is similar to hydrocodone bitartrate 10 mg

Indicated for chronic severe pain:

Apply the buccal film to the buccal mucosa every 12 hours

Opioid naïve
Initial dose-75mcg buccal film every day
If tolerated, apply the film every 12 hours for four days.
Patients should be titrated up to a dosage that works best for them regarding analgesia and side effects at 150 mcg every 12hr intervals at most every four days.
Maximum dose-450mcg every 12 hours.


Conversion from other opioids
buprenorphine may cause opioid withdrawal in patients.
Before starting buprenorphine buccal, taper patients ≤30 mg oral morphine sulfate equivalents (MSE) daily to minimize opioid withdrawal.
After the analgesic taper, base the beginning dosage on the patient's previous daily opioid dose, as stated.
<30 mg/day oral morphine equivalent: Begin with 75 mcg daily or every 12 hours.
30 to 89 mg/day equivalent of oral morphine : Begin with 150 mcg every 12 hours.
90-160 mg/day oral morphine equivalent: Begin with 300 mcg every 12 hours.
>160 mg/day oral morphine equivalent: Consider using a different analgesic.
buprenorphine buccal dosages of 600 mcg, 750 mcg, and 900 mcg are only used after titration from lower doses.
Individual titration should be done in increments of 150 mcg every 12 hours, no more than every four days.


methadone Conversion
methadone to buprenorphine buccal conversion requires close monitoring.
Previous dosage exposure affects methadone-opioid agonist ratios.
methadone's lengthy half-life allows plasma accumulation.
Maintenance and titration dose
The minimum titration period is four days based on the pharmacokinetic profile and steady-state plasma levels.
Individual titration should be at most 150 mcg every 12hr.
Do not exceed 900 mcg every 12hr due to QTc interval lengthening.
Consider a substitute analgesic if buprenorphine buccal 900 mg is insufficient to control pain.
Breakthrough pain may need buprenorphine dosage modification or rescue therapy with a suitable immediate-release painkiller.

Dose Adjustments

Renal impairment
No dosage adjustment is necessary

Hepatic impairment
Mild (Child-Pugh A): No dose change is needed.
Moderate (Child-Pugh B): No dosage change is needed, but monitor for toxicity or overdose symptoms.
Severe (Child-Pugh C): From 150 mcg to 75 mcg, half the beginning and titration dosage of individuals with normal liver function.

Indicated for Gum Pain/Dental/Cold sores:

Apply to the oral mucosa or gums, leave on for one minute, and then expel.
Apply at least four times each day for a maximum of seven days.
Allow the lozenge to melt gently in the mouth; repeat for every two hours as needed.

In the patients receiving opioid analgesics (60 mg or more morphine per day or 50 mcg fentanyl transdermally every hour)
Titrate the medication to a tolerable and effective dose
Abstral- Initially, 100 mcg sublingually; give the next dose not before 4 hours
Actiq- Dissolve 200 mcg in the mouth for at least 15 minutes as required
Titrate it upto 1600 mcg
Fentora- Initially 100 mcg; give the dose again 30 minutes later
Keep the buccal tablet between the cheek & gum until it dissolves
Subsys- Initially, 100 mcg sublingually and titrate the dose

indicated for topical pain
apply ointment directly to the affected area, usually for three to four times daily
It is crucial to adhere to a maximum dosage of 30 grams/day

Take 15-60 mg orally every 4-6 hours as needed
not exceed a daily dose of 360 mg in new patients

Indicated for Sore Throat, Fever, Minor Aches, Cough, Rhinorrhea, Headache & Pains
:

Administer 1 to 2 Tablespoons (15 to 30mL) orally four times a day;
Do not exceed the total dose of 4 g/day acetaminophen and 120 mg/day dextromethorphan
Administer 2 capsules orally four times a day
Do not exceed 8 capsules/day

Indicated for Rhinorrhea, Sore Throat, Fever, Congestion, Cough, Headache, Minor Aches, and Pains
:

Administer two capsules every 4 hours whenever needed.
Do not exceed 12 capsules/day.

Inidcated for Rhinorrhea, Cough, Headache, Nasal Congestion, Sore Throat, Fever
:

Administer 30 mL orally every 6 to 8hr; Do not exceed 4 doses daily

Indicated for Pain
Pending FDA approval, the injection form of the pitcher plant extract which is given by healthcare professional is useful to treat pain

Apply on affected region of skin in every 6 to 8 hours, as needed

<65 years: 31.5 mg every 6 to 8 hours and not more than 126 mg daily
<50 kg or ≥65 years: 15.75 mg every 6 to 8 hours and not more than 63 mg daily
Dosage Modifications
Renal impairment
1 spray in 1 nostril
Total dose: 15.75 mg intranasal every 6 to 8 hours and not more than 4 doses
Hepatic Impairment
Use cautiously

Tablet: 15 to 60 mg of codeine/dose taken orally every 4 to 6 hours and the maximum daily dose is 360 mg of codeine or 4 g of acetaminophen
Oral solution: Take 15 ml orally every 4 hours as needed and the maximum daily dose not more than 4 g of acetaminophen

or substance abuse
:

caryophyllene, a natural compound found in plants like cloves and black pepper, is currently being investigated for its potential health benefits. Studies suggest that caryophyllene may have anti-inflammatory & antioxidant properties, making it useful for various health conditions

Apply topical gel/ cream on to the affected area 3-4 times a day

Initially, administer 5mg intravenously every 2 to 4 hours or 10mg intramuscularly every 3 to 6 hours.
Maximum dose: Administer 10 mg intravenously and 20mg intramuscularly.

Take a dose of 25 to 50 mg orally and repeat every 6 hours if required
Take a dose 25 to 50 mg subcutaneously or intramuscularly and repeat every 4 to 6 hours
Dose not more than 200 mg in a day

Indicated for pain management
Peri & postoperative pain (epidural infusion)- Administering a solution of 0.0625% at a rate of 10 -15 mL every hour, alternatively, infusing a 0.125% solution at the same rate of 10-15 mL every hour, or utilizing a 0.25% solution at 5-7.5 mL every hour
Administer at a maximum rate of 18.75 mg every hour
Maintain maximum cumulative dose at 400 mg each day Nevertheless, patients have shown good tolerance to postoperative dosages as high as 570 mg/24 hours (epidural bolus) in labor pain
: Administer 6-20 ml of solution with 0.25 % concentration
(epidural infusion) in Labor pain-Administer a solution containing 0.0625% concentration at a rate of 10-15 mL every hour
alternatively, administer a solution with 0.125% concentration at a rate of 4-10 mL every hour
Administer at a maximum rate of 12.5 mg every hour Maintain maximum cumulative dose at 400 mg each day

Take a dose of 12.5 mg orally every 4 to 6 hours
Daily dose not more than 75 mg

Take a dose of 8 to 16 mg orally daily
Daily dose not more than 24 mg

Put 1 to 2 drops into the eye for 3 to 8 times daily

The suggested maximum dose is 600 mg daily

Tablets

Oral

Adult oral dosage is 200 to 400 milligrams (mg) daily in two divided doses for symptomatic treatment of upper respiratory tract, genitourinary, and osteoarticular INFLAMMATION and PAIN of various etiologies
A single 100 to 200 mg dose is sufficient for minimal pain. As with other nonsteroidal anti-inflammatory medicines (NSAIDs), an initial 2- to 3-week period on recommended dosage may be required to maximum symptomatic relief, following which dosage should be lowered to the lowest effective level achievable

Adult oral dosage is upto 600 milligrams (mg) daily in two divided doses for symptomatic treatment of upper respiratory tract, genitourinary, and osteoarticular INFLAMMATION and PAIN of various etiologies
A single 100 to 200 mg dose is sufficient for minimal pain
As with other nonsteroidal anti-inflammatory medicines (NSAIDs), an initial 2- to 3-week period on recommended dosage may be required to maximum symptomatic relief, following which dosage should be lowered to the lowest effective level achievable

Dose Adjustments

Limited data is available

It is used to relieve pain and inflammation with a usual recommended dose of 100-200 mg via oral administration can be taken in divided doses

Dose Adjustments

Limited data is available

Off-label:

30 - mg

Tablets

Oral

3 - 4 times a day

Do not exceed 180mg (6 tablets) a day

Cancer:

100 to 200 mg is used initially as an anti-inflammatory & analgesic. Later, it was withdrawn due to severe gastrointestinal bleeding

Apply about 1 g of gel or foam to the affected area(s) every 2-4 times a day. The maximum dose is 25 g a day, irrespective of the affected areas. After 14 days, review the therapy

Indicated for moderate to severe acute pain
Initial dose: Administer 1.5 mg of oliceridine intravenously
Supplemental dose: Administer 0.75 mg of oliceridine intravenously every hour as needed, starting 1 hour after the initial dose
Maximum single dose: The maximum recommended single dose of oliceridine is 3 mg
Maximum daily dose: The maximum recommended daily dose of oliceridine is 27 mg

(Off-label)
Effective dose: 31.33mg/kg
The drug is pending approval from the regulatory agency as the phase III clinical trials are successful.
It is indicated for the management of pain and inflammation in osteoarthritis, possessing lesser effects on the gastrointestinal system compared to other NSAIDs.

200

mg

Tablets

Orally 

4 to 8 times a day

The usual recommended dose is 200mg orally every 4 hours indication: it is usually indicated in the treatment of moderate pain

The contents of the bottle must be inhaled using the inhaler device as needed.
When finished, a third 3 ml dose might be given if more analgesia is needed.
6 milliliters is the maximum total dose per treatment session.
It is advised to refrain from administering medication on consecutive days. The weekly total dosage shouldn't be more than 15ml
indications: it is indicated in the treatment of moderate to severe pain

One tablet or one sachet orally, three times daily, as necessary for five days
Maximum dose: not more than 3 tablets per day indications: it is indicated for the treatment of moderate to severe pain

Off-label
In vivo study on mice suggests that the drug produces antinociceptive activity in mice at doses of 600mg/kg and 900mg/kg.

Its main use is in the treatment of certain soft tissue illnesses that cause pain and inflammation as well as persistent arthritic diseases
One to two tablets are typically administered to adults, with the possibility of varying dosages (125 mg, 250 mg, or 300 mg) after an 8-hour break
Case-by-case adjustments and customizations are made to the recommended dosage
Treatment might last anywhere from seven to ten days—or even longer—depending on the unique medical needs of each patient
200 mg IV is advised for the treatment of pain after traumatology and ambulatory vascular surgery

Dose Adjustments

Limited data is available

This is indicated for the treatment of pain (moderate to severe)
Acute pain: For sufficient analgesia of acute pain, starting dosages are advised to be in the range between 5–15 mg, 4 or 6 times per day
In order to reduce pain, additional dosage should be titrated upward while keeping an eye out for any possible negative effects
Chronic pain: For patients with chronic pain, it is advised to titrate the dosage gradually upward, beginning at the lowest analgesic dose (2.5 to 10 mg every between four and six hours)
Instead of treating pain after it has begun, the medicine for chronic pain management should be administered at regularly scheduled intervals to prevent pain from returning

Dose Adjustments

Renal dose adjustment
There is no need to change the dosage if CrCl is greater than 60 ml/minute
75% to 50% of the regular dose is advised if CrCl is less than 30 mL/minute

Safety and efficacy is not observed in children below 12
This is indicated for the treatment of pain (moderate to severe)
Acute pain: For sufficient analgesia of acute pain, dosages of 0.05 to 0.15 mg per kg should be administered 4 or 6 times per day with equal intervals of six or four hours
In order to reduce pain, additional dosage should be titrated upward while keeping an eye out for any possible negative effects
Chronic pain: Patients with chronic pain should start at the lowest dose of analgesic medication and titrate it gently upwards
Instead of treating pain after it has begun, the medicine for chronic pain management should be administered at regularly scheduled intervals to prevent pain from returning

20mg orally thrice a day or 40 mg twice a day

Pain (off-label)
According to a 2018 study, the terpene may have anti-analgesic properties, which means that it may prevent CBD, other cannabinoids, and prescription painkillers from having their pain-relieving benefits :

Dose Adjustments

N/A

Indicated for Non-serious arthritic pain:

For a maximum of seven days, apply up to four times a day to the affected region

Take the tablet orally once or twice based on the amount of pain

Take the tablet orally once or twice based on the amount of pain

1 or 2 capsules or tablets for each 4 hours
Maximum dose: 8 capsules or tablets in a day

The suggested daily dose is 1 to 2 gm
Consumed in the form of decoction made from the bark

Indicated for Ear pain congestion
Instill the solution directly into the ear canal, using a drop-wise technique, until the canal is adequately filled
Then, carefully place a piece of gauze into the opening of the ear administer up to 3 times a day for a duration of 2 to 3 days

Indicated for Ear pain
First, warm the bottle, like body temperature. Then, tip your head sideways
Next, squeeze some drops into your ear with the dropper
Keep your head tipped for at least two minutes
After that, gently put a tiny cotton ball in your ear
Take it out a few minutes later Do this routine at night and in the morning for a couple of days until the wax clears

Administer 10mg thrice a day before the day of surgery and in the evening after surgery. Later three times a day for 5 days

<1 year: Safety and efficacy not established
>1 year:0.1-0.2mg/kg SC/IV/IM should be administered every 3-4 hours when necessary
Do not exceed 160mg/day

Mouth pain/Sore throat
>5 years: Dissolve one lozenge in mouth, repeat every 2 hours when necessary
<5 years: Safety and efficacy not established

Teething pain
>4 years: apply 7.5-10% to the affected gum area. Do not exceed every 6 hours
<4 years: Safety and efficacy not established

Age >12 years:

Indicated for Moderate to Severe Pain
1 tablet orally every 3-4hours, increase to 2 tablets if required
Do not exceed 12 tablets a day

Dose Adjustments

Renal Impairment

CrCl if 10–50 mL/min: 75% of the recommended adult dose
CrCl if less than 10 mL/min: 50% of the typical adult dose

Hepatic Impairment

Use caution

1

Tablet

Orally 

every 4 hrs

Do not exceed 6 tablets per day

Indicated for Moderate to Mild Pain:

>12 years: 2 tablets orally four times a day when necessary.
<12 years: Safety and efficacy not established

In children and adolescents, 0.25 mg/kg/day orally in 2-3 divided doses
0.0625-0.125 mg/kg/day to be administered as a single dose or in divided doses
Titrate the dose based on its effectiveness 0.0625 mg/kg in D5W as a 250 ml infusion slowly at 20-40 drops/minute

Indicated for mild to moderate pain <37 kg- 50 mg/kg orally, divided into equal doses 2 times a day
>37 kg-2250 mg orally 2 times a day, divided doses

indicated for Topical pain
Age 2 years or older:(Weight 15 kg or more)-
apply ointment directly to the affected area, usually for three to four times daily
It is crucial to adhere to a maximum dosage of 7.5 grams/day

off-label:

Age(≥12 years)- The dosage of 0.5-1 mg/kg every 4-6 hours as needed
Ensure not to exceed a maximum dose of 60 mg/ dose. Adjust the dosage based on the level of pain relief required
It is advisable to take the minimum effective dosage for the shortest feasible period
Alternatively, the dosage is 15-60 mg orally every 4-6 hours as needed, with a maximum daily limit of 360 mg for patients who are new to the medication

Indicated for Sore Throat, Fever, Minor Aches, Cough, Rhinorrhea, Headache & Pains
:

<12 years: Consult the pediatrician.
>12 years: Administer 2 Tablespoons (30mL) orally four times a day Do not exceed 120ml/day
Administer 2 capsules orally four times a day
Do not exceed 8 capsules/day

Indicated for Rhinorrhea, Sore Throat, Fever, Congestion, Cough, Headache, Minor Aches, and Pains
:

<12 years: Consult the pediatrician
>12 years: Administer 2 capsules every 4 hours whenever needed.
Do not exceed 12 capsules/day

Inidcated for Rhinorrhea, Cough, Headache, Nasal Congestion, Sore Throat, Fever
:

>12 years: Administer 30 mL orally every 6 to 8hr; Do not exceed 4 doses in a day
<12 years: Consult the pediatrician

Apply on affected region of skin in every 6 to 8 hours, as needed in more than two years old
Safety and efficacy not determined in less than two years old

Tablet
For <12 years: avoid use
For ≥12 years: take 0.5 to 1 mg codeine/kg/dose orally every 4 to 6 hours
Take 10 to 15 mg acetaminophen/kg/dose orally every 4 to 6 hours
Alternatively, take 15 to 60 mg/dose for codeine and 300 to 1000 mg/dose for acetaminophen and may repeat dose every 4 hour
Oral suspension
For >12 years: take 15 ml orally every 4 hours as needed

For 3 to 11 years old:
Take a dose of 1 mg/kg suspension orally and administered 45 minutes prior to induction of anesthesia

It is indicated for pain and itching
Safety and efficacy are not seen in pediatrics below 2 years
Children two years of age and up: Apply the ointment as needed, up to three or four times a day
7.5 g is the maximum amount that can be used in a 24-hour period

It is indicated for pain and itching
Safety and efficacy are not seen in pediatrics below 2 years
Children two years of age and up: Apply the ointment as needed, up to three or four times a day
7.5 g is the maximum amount that can be used in a 24-hour period

Indicated for Non-serious arthritic pain:

<12 years: Safety and efficacy not established
12 years to 18 years: Be cautious while using, since not every brands are approved for use in this age range.
Apply to the affected region twice to four times each day for up to seven days.

0.025-2.6 mg/kg every hour intravenously as an infusion

Indicated for Ear pain and Congestion
Insert the solution drop by drop into the ear canal until it is adequately filled
Then carefully insert a piece of gauze into the opening of the ear administer up to 3 times a day for a duration of 2 to 3 days

Indicated for Ear pain
First, warm the bottle, like body temperature. Then, tip your head sideways
Next, squeeze some drops into your ear with the dropper Keep your head tipped for at least two minutes
After that, gently put a tiny cotton ball in your ear
Take it out a few minutes later
Do this routine at night and in the morning for a couple of days until the wax clears

Before opioid exposure
:

2-4mg orally every 6-8 hours when necessary
1-2mg intramuscular/subcutaneous every 6-8 hours when necessary
1mg intravenously slowly every 3-6 hours. Do not exceed 4-8mg every 24 hours

Opiate naïve
2mg orally every 6-8 hours when necessary
1mg intramuscular/subcutaneous every 6-8 hours when necessary
1mg intravenously slowly every 3-6 hours. Do not exceed 4-8mg every 24 hours

One tablet or one sachet orally thrice daily as necessary
Maximum dose: not more than two tablets per day
In well-tolerated individuals, the maximum dose can be increased to three tablets per day

Dose Adjustments

Renal dose adjustments The initial dose given daily should be reduced to two tablets per day

Indicated for Non-serious arthritic pain :

For a maximum of seven days, apply up to four times a day to the affected region