| Analgesics/NSAIDs |
| Aspirin | 3 | 650 to 1,000 mg every four to six hours | G6PD-deficiency, bleeding disorder | GI upset; suppositories may cause rectal irritation |
| Maximal initial dose: 1 g |
| Maximal daily dosage: 4 g |
| Ibuprofen (Motrin) | 3 | 400 to 800 mg every six hours | Aspirin/NSAID-induced asthma | Dizziness, rash, GI upset |
| Maximal initial dose: 800 mg |
| Avoid taking more than 2.4 g per day |
| Naproxen sodium (Anaprox) | 3 | 275 to 550 mg every two to six hours | Aspirin/NSAID-induced asthma | Dizziness, rash, pruritus, GI upset, constipation |
| Maximal initial dose: 825 mg |
| Avoid taking more than 1.5 g per day |
| Ketorolac (Toradol) | 3 | 60 mg IM every 15 to 30 minutes | Aspirin/NSAID-induced asthma, pregnancy, cerebrovascular hemorrhage | Edema, drowsiness, dizziness, GI upset, increased diaphoresis |
| Maximal dosage: 120 mg per day |
| Treatment not to exceed five days |
| Narcotic analgesics |
| Meperidine (Demerol) | 3 | 50 to 150 mg IM or IV | MAOI use within 15 days, pregnancy, lactation | Hypotension, fatigue, drowsiness, dizziness, nausea, vomiting, constipation, muscle weakness, histamine release, respiratory depression |
| Repeat 50 to 150 mg every three to four hours |
| Butorphanol (Stadol) | 4 | One spray (1 mg) in one nostril | Use with caution in patients with impaired renal, hepatic, or pulmonary function, elderly patients, those with CNS depression | Drowsiness |
| Repeat in one hour if needed |
| Maximal daily doses: four |
| Limit use to two days per week |
| Adjunctive therapy |
| Metoclopramide (Reglan) | 2 | 10 mg IV or orally 20 to 30 minutes before or with a simple analgesic, NSAID, or ergotamine derivative | Pheochromocytoma, seizure disorder, GI bleeding, GI obstruction | Restlessness, drowsiness, diarrhea, muscle weakness, dystonic reaction |
| Prochlorperazine (Compazine) | 4 | 25 mg orally or suppository | CNS depression, use of adrenergic blocker | Hypotension, tachycardia, arrhythmias, akathisia, pseudo-parkinsonism, tardive dyskinesia, dystonia, dizziness, xerostomia, constipation, urinary retention, blurred vision, pigmentary retinopathy, nasal congestion, decreased diaphoresis |
| Maximum of three doses per 24 hours |
| Isometheptene, acetaminophen, dichloralphenazone (Midrin) | 3 | Maximal initial dose: two capsules | Hepatic or renal impairment, diabetes, hypertension, glaucoma, alcoholism, cardiac disease, MAOI use within 14 days | Hypertension, dizziness, rash |
| Repeat one capsule per hour to maximal dosage of five capsules per 12 hours and 20 per month; limit use to two days or fewer per week |