Common Pain Medications

Acetaminophen. Ibuprofen. Hydrocodone. Ketorolac. Morphine. Hydromorphone.

Oral Acetaminophen (Tylenol)

  • Give every 4-6 hours
  • Regular strength – 325mg
  • Extra strength – 500mg
  • Maximum Daily Dose – 3000mg

Oral Ibuprofen (Advil)

  • Give every 4-6 hours
  • Regular strength – 200mg
  • Therapeutic Ceiling – 400mg

Oral Hydrocodone-Acetaminophen (Vicodin, Norco)

  • Give ever 4-6 hours
  • Common doses – 5-325mg, 7.5-325mg, and 10-325mg

IV/IM Ketorolac (Toradol)

  • Common dosing – 15-30mg
  • Therapeutic ceiling – 10mg

IV/IM morphine

  • Classic dose (0.1mg/kg)
    • This would be 7-10mg in adults!
  • More COMMON dosing is 4mg
    • Repeat as needed

IV/IM Hydromorphone (Dilaudid)

  • COMMON dosing – 0.5-1mg
  • This drug is notorious for bringing you to peer-review/MM conference
    • Be careful!

Contraindications to NSAIDS

  • Pregnant patients
  • Elderly patients
  • Renal disease patients
  • Cardiac patients
  • GI/ulcer patients

Side Effects of Opiates

  • Sedation
    • No driving
    • Do not mix with alcohol
    • Do not mix with other sedatives
  • Constipation
  • Opiate dependency/addiction

Additional Reading

  • Pain Management In the Emergency Department: A Review (PubMed)
  • Myths in EM: The Anti-Inflammatory Properties of NSAIDS (ACEP Now)


  1. Tim Henry

    Hey! Love the website and how mobile friendly it is. I noticed Ketorolac has a therapeutic ceiling of 10mg listed, Epocrates mentions 120mg/day (or max 60mg/day in older or lower weight populations) Is that or something close to it what you meant or am I totally confused?

    • Zack

      NSAIDS are commonly given in doses that are higher than have actually been shown to be effective. These medicines have a “therapeutic ceiling” beyond which there is minimal additional benefit and significant increase in side effects. The therapeutic ceiling for ketorolac is approximately 10-15mg IV/IM.

© 2024 EM Clerkship, LLC

Theme by Anders NorenUp ↑