OTC analgesic dosing

When recommending an OTC analgesic, discuss the ingredients, directions, and maximum single and daily doses with your patients, as they may not know the right dose for their current pain and might rely on past dosing recommendations. Also address any possible confusion between prescription and OTC pain reliever doses. Below, find patient dosing charts that can guide your discussion and help patients at home.

Download adult dosing charts

Acetaminophen Dosing

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Acetaminophen

The daily limit of acetaminophen is 4,000 mg For your safety, do not take more than this amount in 24 hours

Acetaminophen regular strength for example Tylenol® Regular Strength
AMOUNT	325 mg per pill
DOSE & FREQUENCY	2 pills every 4 to 6 hours while symptoms last
DAILY LIMIT	Do not take more than 10 pills in 24 hours, unless directed by a doctor
Acetaminophen extra strength for example Tylenol® Extra Strength
AMOUNT	500 mg per pill
DOSE & FREQUENCY	2 pills every 6 hours while symptoms last
DAILY LIMIT	Do not take more than 6 pills in 24 hours, unless directed by a doctor
Acetaminophen extended release for example Tylenol® 8HR Arthritis Pain
AMOUNT	650 mg per pill
DOSE & FREQUENCY	2 pills every 8 hours
DAILY LIMIT	Do not take more than 6 pills in 24 hours

Acetaminophen dosing considerations

As a healthcare professional, you may use your discretion to recommend acetaminophen up to 4,000 mg in a 24-hour period for patients whose pain or fever persists.

The OTC maximum daily dose of acetaminophen remains 4,000 mg
Beginning in 2011, companies lowered the labeled total daily dose of acetaminophen in certain acetaminophen-containing OTC products in order to lessen the possibility of accidental overdose from using more than one acetaminophen-containing product at the same time. For example, adults and children 12 years and over are directed not to exceed 3,000 mg in 24 hours (for acetaminophen 500 mg tablet strength) unless directed by a healthcare professional

NSAID Dosing

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NSAIDs

The daily limit of ibuprofen is 1,200 mg For your safety, do not take more than this amount in 24 hours

Ibuprofen for example Motrin® IB and Advil®
AMOUNT	200 mg per pill
DOSE & FREQUENCY	1 pill every 4 to 6 hours while symptoms last (if pain or fever does not respond to 1 pill, 2 pills may be used)
DAILY LIMIT	Do not take more than 6 pills in 24 hours, unless directed by a doctor

The daily limit of naproxen sodium is 660 mg For your safety, do not take more than this amount in 24 hours

Naproxen sodium for example Aleve®
AMOUNT	220 mg per pill
DOSE & FREQUENCY	1 pill every 8 to 12 hours while symptoms last (for the first dose, you may take 2 pills within the first hour)
DAILY LIMIT	Do not take more than 2 pills in any 8 to 12 hour period. Do not take more than 3 pills in 24 hours

The daily limit of aspirin is 4,000 mg For your safety, do not take more than this amount in 24 hours

Aspirin low dose for example Bayer® Low Dose
AMOUNT	81 mg per pill
DOSE & FREQUENCY	4 or 8 pills every 4 hours
DAILY LIMIT	Do not take more than 48 pills in 24 hours
Aspirin regular strength for example Bayer® Regular Strength
AMOUNT	325 mg per pill
DOSE & FREQUENCY	1 or 2 pills every 4 hours, or 3 pills every 6 hours
DAILY LIMIT	Do not take more than 12 pills in 24 hours
Aspirin extra strength for example Bayer® Extra Strength
AMOUNT	500 mg per pill
DOSE & FREQUENCY	1 or 2 pills every 4 to 6 hours
DAILY LIMIT	Do not take more than 8 pills in 24 hours

NSAID dosing considerations

The maximum single and total daily doses for NSAIDs vary, depending on the ingredient and whether the product is prescription or OTC. Example: The ibuprofen Rx maximum daily dose is 3,200 mg, while the OTC maximum daily dose is 1,200 mg.

You may occasionally recommend prescription-strength doses of OTC NSAIDs such as ibuprofen and naproxen. Some patients, however, may continue to believe that these higher doses are appropriate for any future occasion or duration
Specify the dose and duration every time you make a recommendation because the risk of side effects increases with higher doses and longer duration of use. If your recommendation differs from previous occasions, explain to the patient why
Recommend that patients start with a 1-pill dose and increase as needed according to product directions

Counseling points for all OTC analgesics:
Help your patients avoid dosing mistakes

Read and follow the entire Drug Facts label
Check the label for the maximum single and total daily doses, and don’t exceed them
Follow directions. Different pain relievers have different doses. It isn’t safe to apply directions from one pain reliever to another
Store the OTC Pain Reliever Dosing Chart with your medicines, and check it every time
Take ONLY 1 medicine with the same kind of active ingredient (acetaminophen or NSAID) at a time