if NSAIDs are indicated: 200-400 mg ibuprofen or 650 mg aspirin
if NSAIDs are contraindicated: 650-1000 mg acetominophen
if inadequate pain relief, then:
Moderate Pain ( Prescription Drug )
if NSAIDs are indicated: 600-800 mg ibuprofen or 400 mg ibuprofen plus non-narcotic/narcotic combination analgesic equivalent to 60 mg codein (see sample plan)
if NSAIDs are contraindicated: 600-1000 mg acetominophen and narcotic equivalent to 60 mg codeine
if inadequate pain relief, then:
Severe Pain ( Prescription Drug )
if NSAIDs are indicated: 600-800 mg ibuprofen plus non-narcotic/narcotic combination analgesic equivalent to 10 mg oxycodone
if NSAIDs are contraindicated: 1000 mg acetominophen and narcotic equivalent to 10 mg oxycodone
Sample Pain Management Plan
A patient, for example, may present at your office reporting severe pain that kept them awake all night. They deny any contraindications to NSAIDs. After examination, you find the patient is suffering from irreversible pulpitis with acute apical periodontitis, and a root canal procedure is initiated. this patient may well experience some post-appointment pain due to continued inflammation of the periapical tissues.
A pain management plan would be to give this patient two prescriptions:
Rx: ibuprofen 400 mg
Disp: 24 tablets
Sig: take one tablet every 4 hours
Rx: acetominophen 300 mg with 30 mg codeine
Disp: 12 tablets
Sig: take two tablets every 4 hours
The patient will take the medications as follows:
Beginning at your office: 400 mg ibuprofen, 2 tabs acetominophen/codeine (equivalent to 500 mg & 60 mg, respectively)
The patient will then repeat this two-hour dosing schedule throughout the first day.