NSAID Master Table

Cerebral Torque

Use as a resource with your neurologist ONLY.ย 

Class Medication Typical Dose Maximum Dose/24 hr Highlights Forms Half-Life
Acetic Acids Diclofenac 50 mg every 8-12 hrs United States: 150 mg,
200 mg for rheumatoid arthritis
Canada: 100 mg
Diclofenac free acid has different dosing than diclofenac sodium and potassium (seen here). Tab, cap, gel, inj 1-2 hrs
Etodolac 200-400 mg every 6-8 hrs 1000 mg More COX-2 selective than other NSAIDS except for coxibs, which means greater GI tolerability Tab, cap, ER tab 7 hrs
Indomethacin 25-50 mg every 8-12 hrs 150 mg
200 mg for rheumatic diseases

Greater risk of CNS side effects.

May be used as a diagnostic tool to identify paroxysmal hemicrania or hemicrania continua (used as a preventive treatment in both).

More potent at inhibitng prostaglandins in the kidneys than other NSAIDs. Therefore, higher risk of adverse kidnery effects.

Cap, ER cap, supp 4-6 hrs
Sulindac 150-200 mg every 12 hrs 400 mg

Increased risk of nephrolithiasis

Higher risk of liver injury

Tab 7.8 hrs
Ketorolac

20 mg after IV or IM, then 10 mg every 4 to 6 hours (tab)

60/30 mg every 6 hrs (IM/IV)

Nasal spray:

For adult patients <65, โ‰ฅ110 lbs, and normal kidney function:ย 1 spray in EACH nostril every 6-8 hours

For adult patients โ‰ฅ65, <110 lbs, or with renal impairment:ย 1 spray in ONLY ONE nostril every 6-8 hours

40 mg (tab)

120 mg (IM/IV)

4 doses per day, for up to 5 days (Intanasal)

Very potent

Duration of therapy should not exceed 5 days due to adverse effects risk

Tab, inj, nasal 4-6 hrs
Fenamates Meclofenamate 50 mg every 4-6 hrs,
100 mg 3x/day for dysmenorrhea
400 mg For dysmenorrhea Cap 2.5-4 hrs
Mefenamic Acid 250 mg every 6 hrs 1000 mg Only for dysmenorrhea Tab, cap 2-4 hrs
Naphthylalkanones Nabumetone 1000 mg 1-2x/day 2000 mg Preferentially inhibits COX-2 Tab 24 hrs
Oxicams Piroxicam 10-20 mg daily 20 mg

Due to longer half-life, higher risk of GI adverse effects compared to other NSAIDs

Similarly, due to long half-life, good for chronic pain

Cap 50 hrs
Meloxicam

7.5-15 mg daily tab/susp

5-10 mg cap

15 mg tab/susp

10 mg cap

Safer on GI tract than piroxicam due to preferential COX-2 selectivity

Long duration, slower onset so must be careful with repeated use

Tab, cap, susp 15-20 hrs
Propionic Acids Fenoprofen 200 mg every 4-6 hrs or
400-600 mg every 6-8 hrs
3200 mg

Higher risk of photosensitive skin reactions compared to other NSAIDs

Nephrotixicity risk

Tab, cap 2-4 hrs
Flurbiprofen 50 mg every 6 hrs or
100 mg every 8-12 hrs
300 mg May also be in the form of an opthalmic solution to inhibit miosis during cataract surgery Tab 4-6 hrs
Ibuprofen 400 mg every 4-6 hrs
600-800 mg every 6-8 hrs
3200 mg acute
2400 mg chronic

May help prevent altitude sickness when taken prophylactically

Good alternative to naproxen for migraine relief

Tab, cap, liq 2-3 hrs
Ketoprofen 50 mg every 6 hrs or
75 mg every 8 hrs
300 mg Do not uses extended release forumation for acute pain Cap, ER cap 2-4 hrs
Naproxen

250, 500 mg naproxen = 275, 550 mg naproxen sodium

250-500 mg every 12 hrs or
250 mg every 6-8 hrs

1250 mg- short-term use

1000 mg- chronic use

May increase to 1500 mg during a flare.

Commonly combined with sumatriptan for acute migraine tx

Most well-studied for migraine

Drug of choice for those with CVD

Tab, cap, liq, susp 12-15 hrs
Oxaprozin 1200 mg daily 1800 mg Slow onset and long half-life Tab 50-60 hrs
Salicylates Aspirin 325-1000 mg every 4-6 hrs 4000 mg

Not routinely used for migraine relief as there are better alternatives

Only NSAID that reduces risk of myocardial infarction and ischemic stroke, but not for doses necessary for pain relief

Irreversibly inhibits platelet COX-1 activity

Increased risk of bleeding with long-term use

Tab, cap, liq 2-3 hrs
Diflunisal 500 mg every 8-12 hrs 1500 mg Lower GI bleed risk Tab 8-12 hrs
Salsalate 1000 mg every 8-12 hrs or 1500 mg every 12 hrs 3000 mg Lower GI bleed risk Tab 6-10 hrs
Magnesium salicylate 1160 mg every 6 hrs 4640 mg Lower GI bleed risk Tab 2-3 hrs
COX-2 Inhibitors Celecoxib 100 mg twice daily or 200 mg once daily 400 mg

Less GI toxicity than nonselective NSAIDs

Elyxyb oral solution also available specificall for migraine attacks

Cap, liq 11 hrs
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