1st choice Ibuprofen tablets Dose: Initially 300–400mg 3–4 times daily; 200mg, 400mg, increased if necessary to max 2.4g 600mg; syrup daily; maintenance dose of 100mg/5ml daily may be adequate Or Naproxen 250mg, Dose: 500 mg initially, then 250 mg every 6–8 hours as required; max. 500mg; e/c tablets dose after first day 1.25 g daily; 250mg, 500mg 2nd choice Paracetamol tablets Dose: 500mg; soluble 500mg–1g every 4–6 hours; max 4g tablets 500mg; oral daily suspension 120mg/5ml, 250mg/5ml; suppositories 60mg, 125mg, 250mg, 500mg Prescribing Notes For optimal effect, regular analgesics should be initiated just before anticipated onset of menstruation Offer an NSAID first line unless NSAIDs are contraindicated Ibuprofen may be preferred because of its more favourable benefit ratio Offer paracetamol first line if NSAIDs are contraindicated or not tolerated, or in addition to an NSAID if the response is insufficient If the does not wish to conceive, then hormonal contraceptives should be considered as alternative first line treatment (see section 7.3.1 since they may prevent the pain of (add jump)) dysmenorrhoea
1st choice Ibuprofen tablets 200mg, 400mg, 600mg; syrup 100mg/5ml Or Naproxen 250mg, 500mg; e/c tablets 250mg, 500mg Dose: Initially 300–400mg 3–4 times daily; increased if necessary to max 2.4g daily; maintenance dose of daily may be adequate Dose: 500 mg initially, then 250 mg every 6–8 hours as required; max. dose after first day 1.25 g daily; 2nd choice Paracetamol tablets 500mg; soluble tablets 500mg; oral suspension 120mg/5ml, 250mg/5ml; suppositories 60mg, 125mg, 250mg, 500mg Dose: 500mg–1g every 4–6 hours; max 4g daily Prescribing Notes For optimal effect, regular analgesics should be initiated just before anticipated onset of menstruation Offer an NSAID first line unless NSAIDs are contraindicated Ibuprofen may be preferred because of its more favourable ratio Offer paracetamol first line if NSAIDs are contraindicated or not tolerated, or in addition to an NSAID if the response is insufficient If the does not wish to conceive, then hormonal contraceptives should be considered as alternative first line treatment (see section 7.3.1 (add jump)) since they may prevent the pain of dysmenorrhoea benefit
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