4.7.1. Non-opioid analgesics and compound analgesic preparations
Restrictions:
Strengths other than 8/500 or 30/ 500 are non-Formulary. Dispersible and effervescent formulations are considerably more expensive and should be restricted to patients with swallowing difficulties. Their high sodium content (up to 8g daily) exceeds the WHO daily salt intake recommendation of 6g daily and may compromise the treatment of hypertension, heart failure and renal disease.
Prescribing Notes:
There is no evidence that the 8/500 strength is any more effective than paracetamol alone.
Restrictions:
Use of MR preparations is restricted (see notes below).
Prescribing Notes:
Modified-release preparations of any NSAID should be restricted to patients with early morning stiffness or compliance problems as they encourage regular/higher doses of NSAIDs and do not afford flexibility in reducing the dose.
Restrictions:
Dispersible and effervescent formulations are considerably more expensive and should be restricted to patients with swallowing difficulties. Their high sodium content (up to 8g daily) exceeds the WHO daily salt intake recommendation of 6g daily and may compromise the treatment of hypertension, heart failure and renal disease.
Prescribing Notes:
Paracetamol 500mg tablet is the preferred formulation for use in adults.
Consider dose reduction in patients with low body weight (< 50kg), renal/hepatic impairment or glutathione deficiency (chronic malnourishment, chronic alcoholism) to 15 mg/kg/dose up to four times daily (max 60mg/kg/day) An example is: paracetamol oral 500 mg four times daily.
Restrictions:
Only the 10/500 (10mg dihydrocodeine, 500mg paracetamol) strength of tablets are included in the Formulary.
Prescribing Notes:
Remedeine® and Remedeine Forte® remain non-formulary.
Restrictions:
Restricted to specialist use only for the emergency relief of moderate to severe pain in conscious adult patients with trauma and associated pain.