Pain relief guidelines

Mild to moderate pain

1000mg paracetamol four times daily

Or 400mg ibuprofen three times daily

Moderate to severe pain

400–600mg ibuprofen three to four times daily*

And 1000mg paracetamol four times daily

Breakfast

1000mg paracetamol 400–600mg ibuprofen

Lunch

1000mg paracetamol 400–600mg ibuprofen

Dinner

1000mg paracetamol 400–600mg ibuprofen

Before bed

1000mg paracetamol 400–600mg ibuprofen

Or the alternative is to stagger the doses of paracetamol and ibuprofen over 24 hours. If this regimen is used, ensure that ibuprofen is taken with food.

Avoid ibuprofen if:

• You have a hypersensitivity to aspirin or any other non-steroidal anti-inflammatory drug (NSAID), including if you have experienced attacks of asthma, angioedema, urticaria or rhinitis precipitated by aspirin or another NSAID
• You have active peptic ulcer disease or a history of NSAID-associated ulcer disease
• You are in the third trimester of pregnancy
• You have severe heart failure
• You are taking any other NSAID painkillers

Use ibuprofen with caution if:

• You have a history of asthma or other allergic disease, bowel problems, ulcerative colitis, Crohn’s disease or connective tissue disorders
• You have severe renal, cardiac or hepatic impairment
• You are elderly
• You have uncontrolled hypertension
• You have coagulation defects or inherited bleeding disorders
• You are in the first 6 months of pregnancy
• You are breastfeeding
• You are taking the following medicines: anticoagulants, antihypertensives, methotrexate, selective serotonin reuptake inhibitor (SSRIs), lithium, antiplatelet agents

Avoid paracetamol if:

• You have a hypersensitivity to paracetamol or any of its formulations

Use paracetamol with caution if:

• You have severe hepatic or renal impairment

Age 6 months–1 year

120mg every 4–6 hours, maximum 4 times per day

Age 2–3 years

180mg every 4–6 hours, maximum 4 times per day

Age 4–5 years

240mg every 4–6 hours, maximum 4 times per day

Age 6–7 years

240–250mg every 4–6 hours, maximum 4 times per day

Age 8–9 years

360–375mg every 4–6 hours, maximum 4 times per day

Age 10–11 years

480–500mg every 4–6 hours, maximum 4 times per day

Age 12–15 years

480–750mg every 4–6 hours, maximum 4 times per day

Age 16–17 years

0.5–1g every 4–6 hours, maximum 4 times per day

Age 6 months–11 months

50mg 3 times a day, maximum daily dose in 3–4 divided doses; max 30mg/kg per day

Age 1–3 years

100mg 3 times a day, maximum daily dose in 3–4 divided doses; max 30mg/kg per day

Age 4–6 years

150mg 3 times a day, maximum daily dose in 3–4 divided doses; max 30mg/kg per day

Age 7–9 years

200mg 3 times a day, maximum daily dose in 3–4 divided doses; max 30mg/kg per day up to max 2.4g per day

Age 10–11 years

300mg 3 times a day, maximum daily dose in 3–4 divided doses; max 30mg/kg per day up to max 2.4g per day

Age 12–17 years

Initially 300–400mg 3–4 times a day (up to 600mg 4 times a day); maintenance 200–400mg 3 times a day