Non-opioid and compound analgesics
Drug Safety Update
June 2023: Non-steroidal anti-inflammatory drugs (NSAIDs): potential risks following prolonged use after 20 weeks of pregnancy
January 2018: Co-dydramol: prescribe and dispense by strength to minimise risk of medication error.
 January 2017: Intravenous N-acetylcysteine (NAC) for paracetamol overdose: reminder of authorised dose regimen; possible need for continued treatment with NAC.Â
 December 2014: Treating paracetamol overdose with intravenous acetylcysteine: new guidance
 NICE CKS (Clinical Knowledge Summaries) Analgesia - management of mild to moderate pain September 2015
Paracetamol has similar efficacy to aspirin but has no anti-inflammatory effect and does not cause gastritis/gastric uleration.
Paracetamol injection is available for post-operative pain in selected patients only where the oral route cannot be used.Â
 MTW NHS Trust Protocol for the use of intravenous paracetamol updated 2019
 Royal College of Emergency Medicine (RCEM) Paracetamol overdose new guidance on the use of intravenous acetylcysteine.
A new weight-based dosing table and a technical information leaflet to help calculate the dose of acetylcysteine infusions to minimise the risk of dosing errors are available to downloadÂ
Methoxyflurane is approved for use within the Emergency Department ONLY for the emergency relief of moderate to severe pain in conscious adults patients with trauma and associated pain, where they would otherwise require procedural sedation.
Please see eMC via link below to access the risk materials associated with this treatment (admin checklist and guide) . The Procedural Penthrox Checklist produced by MTW ED should also be used. Methoxyflurane should only be self-administered under the supervision of personnel trained and experienced in its use, using a hand-held Penthrox inhaler device. Patients should be given advice on appropriate inhaler technique and given a patient alert card (found via eMC link).
| Pack | Price |
|---|---|
| 100 tablet | £3.90 |
| 100 tablet (10 x 10 tablets) | £2.47 |
| 1000 tablet | £28.40 |
| 16 tablet (2 x 8 tablets) | £0.36 |
| 30 tablet (3 x 10 tablets) | £1.07 |
| 32 tablet | £0.67 |
| Pack | Price |
|---|---|
| 100 capsule (10 x 10 capsules) | £3.30 |
| 16 capsule | £0.50 |
| 32 capsule | £1.00 |
| Pack | Price |
|---|---|
| 100 tablet (10 x 10 tablets) | £23.20 |
| 24 tablet (4 x 6 tablets) | £10.64 |
| 60 tablet | £8.80 |
| Pack | Price |
|---|---|
| 100 ml | £6.28 |
| 500 ml |
| Pack | Price |
|---|---|
| 100 ml | £3.78 |
| 1000 ml | |
| 200 ml | £7.56 |
| Pack | Price |
|---|---|
| 100 ml | £6.40 |
| 500 ml | £31.70 |
| Pack | Price |
|---|---|
| 100 ml | £4.54 |
| 1000 ml | £42.00 |
| 200 ml | £9.08 |
| 500 ml | £22.70 |
| Pack | Price |
|---|---|
| 10 suppository | £11.95 |
| Pack | Price |
|---|---|
| 10 suppository | £34.60 |
| Pack | Price |
|---|---|
| 10 suppository | £62.31 |
| Pack | Price |
|---|---|
| 10 suppository | £41.27 |
| Pack | Price |
|---|---|
| 10 vial |
| Pack | Price |
|---|---|
| 24 tablet | £0.50 |
| 48 tablet (4 x 12 tablets) | £2.38 |
| 84 tablet | £2.63 |
| Pack | Price |
|---|---|
| 24 tablet | £2.25 |
| 48 tablet (4 x 12 tablets) | £1.00 |
| 84 tablet (7 x 12 tablets) | £2.63 |
| Pack | Price |
|---|---|
| 100 ml | £2.16 |
| 150 ml | £5.30 |
| 500 ml |
| Pack | Price |
|---|---|
| 56 tablet (4 x 14 tablets) | £3.90 |
| Pack | Price |
|---|---|
| 56 tablet (4 x 14 tablets) | £7.50 |
| Pack | Price |
|---|---|
| 100 ml |
Consider prescribing codeine and paracetamol separately for greater flexibility of dosing and titration to pain.
| Pack | Price |
|---|---|
| 100 tablet | £3.27 |
| 1000 tablet | |
| 12 tablet | |
| 16 tablet | |
| 24 tablet | |
| 30 tablet | £0.98 |
| 32 tablet | |
| 4 tablet | |
| 48 tablet | |
| 50 tablet | |
| 500 tablet | |
| 8 tablet |
Consider co-prescribing with a laxative as this can cause severe constipation with more regular use
| Pack | Price |
|---|---|
| 100 tablet | £3.93 |
| 30 tablet | £1.18 |
| 500 tablet |
| Pack | Price |
|---|---|
| 10 capsule | |
| 100 capsule | £28.58 |
| 20 capsule | |
| 24 capsule | |
| 32 capsule | £9.02 |
Consider co-prescribing with a laxative as this can cause severe constipation with more regular use
| Pack | Price |
|---|---|
| 100 capsule | £5.24 |
| 24 capsule | |
| 30 capsule | |
| 8 capsule |
These tablets have a high sodium content reserve use for swallowing difficulty only and do not use in renal impairment
| Pack | Price |
|---|---|
| 100 tablet | £8.00 |
| 12 tablet | |
| 24 tablet | |
| 32 tablet | £2.56 |
| 60 tablet |
These tablets have a high sodium content reserve use for swallowing difficulty only and do not use in renal impairment
Consider co-prescribing with a laxative as this can cause severe constipation with more regular use
| Pack | Price |
|---|---|
| 100 tablet | £7.88 |
| 30 tablet | |
| 32 tablet | £2.52 |
| 90 tablet |
Co-dydramol is available in different strengths 10/500, 20/500 and 30/500 - when prescribing clearly indicate the tablet strength and dose
| Pack | Price |
|---|---|
| 100 tablet | £6.03 |
| 30 tablet | £1.81 |
| 500 tablet |
Approved for use within the Emergency Department only for:
Emergency relief of moderate to severe pain in conscious adults patients with trauma and associated pain, where they would otherwise require procedural sedation
| Pack | Price |
|---|---|
| 1 bottle | £18.46 |