Pharmacokinetic properties and dosing schedules of NSAIDs
| Pharmacokinetic properties and dosing schedules |
The pharmacokinetic properties and adult dosing schedules of NSAIDs are summarised in Table 1.2 below. See also Table 1.19 for recommended paediatric doses for oral NSAIDs.
Pharmacokinetic properties and adult dosing schedules of NSAIDs (Table 1.2)
| Drug | Formulations / routes of administration | Time to peak concentration (hours) | Elimination half-life (hours) | Dose range (mg) | Dosing interval (hours) | Maximum daily dose (mg) | |
| aspirin | oral | 1 to 2 | 0.25 [NB1] | 300 to 900 | 4 to 6 | 3600 | |
| celecoxib | oral | 2 to 5 | 4 to 15 | 100 to 200 | 12 to 24 | 400 | |
| diclofenac | oral [NB2] | 2 | 1 to 2 | 25 to 50 | 8 to 12 | 200 | |
| suppository [NB3] | 0.6 | more than 1 to 2 [NB3] | 50 to 100 | 12 to 24 | | ||
| ibuprofen | oral (including suspension) [NB2] | 0.5 to 1.5 | 2 to 2.5 | 200 to 400 | 6 to 8 | 2400 | |
| indomethacin | oral | 2 | 4.5 | 25 to 100 | 6 to 12 | 200 | |
| suppository | less than 2 | 100 | 12 to 24 | | |||
| ketoprofen | 0.5 to 2 | 1.5 | 50 to 100 | 6 to 12 | 200 | ||
| suppository | 1 | 1.5 | 100 | 24 | | ||
| ketorolac | oral | 0.5 | 4 to 6 [NB5] | 10 | 4 to 6 [NB5] | 30 to 40 [NB5] | |
| injection | 1 | 4 to 6 [NB5] | 10 to 30 | 4 to 6 [NB5] | 60 to 90 [NB5] | ||
| mefenamic acid | oral | 2 to 4 | 3 to 4 | 500 | 8 | 1500 | |
| meloxicam | oral | 5 to 6 | 20 | 7.5 to 15 | 24 | 15 | |
| naproxen | oral (including suspension) [NB4] | 2 to 4 | 15 | 250 to 500 | 6 to 12 | 1250 | |
| parecoxibNB6] [ | injection | 0.5 to 1 | 3.5 to 4 (active metabolite 8) | 40 [NB7] | single dose only | 40 [NB7] | |
| piroxicam | oral [NB2] | 2 to 4 | 53 | 10 to 20 | 24 | 20 | |
| sulindac (sulfide) | oral | 2 to 4 | 7 (active metabolite 16) | 100 to 400 | 12 to 24 | 400 | |
| tiaprofenic acid | oral | 1.5 | 3 | 150 to 300 | 8 to 12 | 600 | |
| NB1: metabolised to salicylate; as the daily dose of aspirin increases to 2 g and above, the dosing interval can be increased because the half-life of salicylates increases with dose NB3: maximum serum concentration after suppository is less than with oral, and total exposure to the drug is comparable despite a longer half-life NB5: mean half-life of ketorolac is longer in patients aged over 65 years (7 hours, with a dosing interval of 6 to 8 hours) and in renally impaired patients (6 to 19 hours). The lower maximum daily dose applies in patients aged over 65 years and in those with mild renal impairment. Use of ketorolac is contraindicated in patients with moderate to severe renal impairment | |||||||
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