Hesperian Health Guides

Medicines for Pain

Medicines for mild pain and lowering fever include paracetamol (the safest and best medicine to use for children), aspirin, and ibuprofen. Aspirin and ibuprofen also reduce inflammation (swelling). Reducing swelling will calm pain and help heal injuries such as a twisted or sprained ankle. For children with fevers and viral infections, give paracetamol and avoid aspirin.

Do not give more than the recommended dose of these medicines. Too much aspirin or ibuprofen can cause stomach ulcers. Too much paracetamol can be poisonous. For high fever or very strong pain, avoid using too much of any one pain medicine by using both paracetamol and ibuprofen in the correct doses and intervals.

Paracetamol, acetaminophen


Paracetamol is a good, affordable medicine for fever and mild pain.

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Do not take more than the recommended amount. Too much is poisonous to the liver and can kill. Keep this medicine out of the reach of children, especially if you have it as a sweetened syrup.

Cold medicines often contain paracetamol, so do not give them if you are also giving paracetamol or you may give too much.

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Give 10 to 15 mg per kg, every 4 to 6 hours. Do not give more than 5 times in 24 hours. If you cannot weigh the person, dose by age:
Under 1 year: give 62 mg (half of ¼ of a 500 mg tablet), every 4 to 6 hours.
1 to 2 years: give 125 mg (¼ of a 500 mg tablet), every 4 to 6 hours.
3 to 7 years: give 250 mg (½ of a 500 mg tablet), every 4 to 6 hours.
8 to 12 years: give 375 mg (¾ of a 500 mg tablet), every 4 to 6 hours.
Over 12 years: give 500 mg to 1000 mg, every 4 to 6 hours, but do not give more than
4000 mg in a day.

Ibuprofen


Ibuprofen relieves muscle pain, joint pain, and headache, and lowers fever.

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Ibuprofen can cause a stomachache, but taking it with milk or food lessens that problem.

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Do not take ibuprofen if you are allergic to aspirin. Some people who are allergic to one are also allergic to the other. Do not give ibuprofen for stomach pain or indigestion. Ibuprofen is acidic and may make the problem worse. For the same reason, people with stomach ulcers should never use ibuprofen. Do not give ibuprofen to babies younger than 6 months, and do not give to pregnant women in their last 3 months of pregnancy.

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Give 5 to 10 mg per kg,every 6 to 8 hours. If you cannot weigh the person, dose by age.
6 months to 12 months: give 50 mg, every 6 to 8 hours.
1 to 2 years: give 75 mg, every 6 to 8 hours.
2 to 3 years: give 100 mg, every 6 to 8 hours.
4 to 5 years: give 150 mg, every 6 to 8 hours.
6 to 8 years: give 200 mg, every 6 to 8 hours.
9 to 10 years: give 250 mg, every 6 to 8 hours.
11 years: give 300 mg, every 6 to 8 hours.
Over 12 years: give 200 to 400 mg, every 4 to 6 hours.

Do not give more than 40 mg per kg in a day. Do not give more than 4 doses a day, and do not give for more than 10 consecutive days.

Aspirin (acetylsalicylic acid)


Aspirin is a good, affordable medicine for fever and mild pain.

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Aspirin can cause stomach pain or heartburn. To avoid this, take aspirin with milk, a little bicarbonate of soda, or a lot of water—or together with meals.

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  • Do not give aspirin for stomach pain or indigestion. Aspirin is acidic and may make the problem worse. For the same reason, people with stomach ulcers should never use aspirin.
  • Do not give more than 1 dose of aspirin to a dehydrated person until he begins to urinate well.
  • It is better not to give aspirin to children under 12 years and especially not to babies (paracetamol is safer) or to someone with asthma (this may bring on an attack). Do not give to children with flu signs, as this can cause problems.
  • Keep aspirin where children cannot reach it. Large amounts can poison them.
  • Do not give to pregnant women.
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1 to 2 years: give 75 mg, every 6 hours.
3 to 7 years: give 150 mg, every 6 hours.
8 to 12 years: give 300 mg, every 6 hours.
Over 12 years: give 300 to 600 mg, every 4 to 6 hours.

Do not give more than 2400 mg a day. Do not give to children more than 4 times a day.

For heart attack
Give 300 to 325 mg by mouth immediately. Chew it up and swallow it.

Codeine (codeine sulfate)


Codeine is a medicine for pain in the opiate family. It is used to treat severe pain. Only use codeine when milder pain medicines do not work.

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May cause constipation (difficulty passing stools) and temporary inability to pass urine. May also cause nausea, vomiting, itching, and headaches.

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  • Codeine is a habit-forming (addictive) drug. Avoid long-term or frequent use.
  • Do not drink alcohol while using codeine as it can cause dangerous side effects and even death.
  • Codeine can affect your thinking and reactions while taking it. Be careful when driving or doing other things that require you to be alert.
  • Reduce the dose over time to stop taking it. Stopping all at once can cause uncomfortable withdrawal symptoms.
  • Do not use codeine if you have ever had an allergic reaction to morphine.
  • Do not use codeine if you are pregnant or breastfeeding.
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Give codeine along with food.
3 to 6 years: give ½ to 1 mg per kg by mouth, every 4 to 6 hours.
7 to 12 years: give 15 to 30 mg by mouth, every 4 to 6 hours.
Over 12 years: give 15 to 60 mg by mouth, every 4 to 6 hours. Do not give more than
360 mg per day.

Morphine (morphine sulfate, or morphine hydrochloride)


Morphine is medicine for pain in the opiate family, used to treat moderate to severe pain.

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  • Morphine is a habit-forming (addictive) drug. Avoid long-term or frequent use.
  • Do not drink alcohol while using morphine as it can cause dangerous side effects and even death.
  • Morphine can affect your thinking and reactions while taking it. Be careful when driving or doing other things that require you to be alert.
  • Reduce the dose over time to stop taking it. Stopping all at once can cause uncomfortable withdrawal symptoms.
  • Do not use morphine if you have ever had an allergic reaction to codeine.
  • Do not use morphine if you are pregnant or breastfeeding.
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For moderate to severe pain

Under 6 months: give 0.1 mg per kg by mouth, every 3 to 4 hours. If you cannot weigh the baby, give 0.5 mg by mouth, every 3 to 4 hours.
Over 6 months: give 0.2 to 0.5 mg per kg by mouth, every 4 to 6 hours as needed.
If you cannot weigh the person, dose by age:
6 months to 1 year: give 2 mg by mouth, every 4 to 6 hours.
1 to 5 years: give 3 mg by mouth, every 4 to 6 hours.
6 to 12 years: give 8 mg by mouth, every 4 to 6 hours.
Over 12 years: give 10 to 30 mg by mouth, every 4 hours as needed.


For heart attack
Slowly inject 10 mg into the muscle over 5 minutes (2 mg per minute). Inject another 5 to 10 mg if necessary.


This page was updated:30 Apr 2020