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Appendix: Formulary

Mark Dershwitz; Carl Rosow

Table A-1 Analgesic Agents
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Table A-1 Analgesic Agents
DrugRouteUsual DoseHow SuppliedFormCost*
Oral COX Inhibitors
AcetaminophenPO325-1000 mg325, 500 mgTablet0.01
AspirinPO325-1000 mg325, 500 mgTablet0.05
CelecoxibPO100-400 mg

100 mg

200 mg

400 mg

Capsule

Capsule

Capsule

2.03

3.32

4.98

Choline magnesium trisalicylatePO500-1000 mg

500 mg

1000 mg

Caplet

Caplet

0.35

0.86

DiclofenacPO50-75 mg

50 mg

75 mg

Tablet

Tablet

0.80

1.10

DiflunisalPO500-1000 mg500 mgTablet0.66
IbuprofenPO200-800 mg

200 mg

400 mg

600 mg

800 mg

Tablet

Tablet

Tablet

Tablet

0.02

0.04

0.05

0.08

IndomethacinPO25-50 mg25 mgCapsule0.04
KetorolacPO10 mg10 mgTablet0.68
NaproxenPO250-500 mg

250 mg

375 mg

500 mg

Tablet

Tablet

Tablet

0.10

0.08

0.08

Piroxicam

PO

PO

10-40 mg

10 mg

20 mg

Capsule

Capsule

0.09

0.11

SulindacPO150 mg150 mgTablet0.33
Oral Opioids
CodeinePO30-60 mg

30 mg

60 mg

Tablet

Tablet

0.47

0.86

Codeine/acetaminophenPO30-60 mg/300 mg

30/300 mg

60/300 mg

Tablet

Tablet

0.47

0.75

Hydrocodone/acetaminophenPO5-7.5 mg/500-1000 mg

5 mg/500 mg

7.5 mg/750 mg

Tablet

Tablet

0.15

0.27

HydromorphonePO2-4 mg2 mgTablet0.36
LevorphanolPO2 mg2 mgTablet0.80
MethadonePO10-20 mg10 mgTablet0.18
MorphinePO30-60 mg

30 mg

2 mg/mL, 5 mL

Tablet

Solution

0.23

0.58

Morphine sustained releasePO30-60 mg30 mgCaplet1.20
OxycodonePO5-10 mg5 mgTablet0.26
Oxycodone/acetaminophenPO5-10 mg/500-1000 mg5 mg/500 mgCaplet0.20
Oxycodone sustained releasePO10-20 mg

10 mg

20 mg

40 mg

80 mg

Tablet

Tablet

Tablet

Tablet

1.52

2.93

5.18

9.75

TramadolPO50-100 mg50 mgTablet0.09
Tramadol/acetaminophenPO75 mg/650 mgTablet0.77
Transdermal and Transmucosal Opioids
FentanylTransdermal25-100 mcg/h

25 mcg/h

50 mcg/h

75 mcg/h

100 mcg/h

Patch

Patch

Patch

Patch

9.75

17.81

27.17

36.05

FentanylTransbuccal200-1600 mcg

200 mcg

400 mcg

800 mcg

Lozenge

Lozenge

Lozenge

17.67

25.68

41.08

Parenteral COX Inhibitors
AcetaminophenIV1000 mg10 mg/mL, 10 mLSolution10.60
Ketorolac

IV

IM

30 mg

60 mg

30 mg/mL, 1 mL

30 mg/mL, 2 mL

Solution

Solution

1.00

1.07

Parecoxib§IV/IM20-40 mg40 mgPowder§
Parenteral Opioids
AlfentanilIV0.3-3 mcg/kg/min

500 mcg/mL, 2 mL

500 mcg/mL, 5 mL

Solution

Solution

3.87

7.25

CodeineIV/IM30-60 mg30 mg/mL, 2 mLSolution2.18
FentanylIV0.5-5 mcg/kg

50 mcg/mL, 2 mL

50 mcg/mL, 5 mL

50 mcg/mL, 20 mL

Solution

Solution

Solution

0.53

0.72

2.70

HydromorphoneIV/IM0.5-2 mg2 mg/mL, 1 mLSolution0.68
MeperidineIV/IM/SC12.5-100 mg100 mg/mL, 1 mLSolution0.63
MethadoneIV1-10 mg10 mg/mL, 20 mLSolution101.25
MorphineIV/IM/SC1-10 mg10 mg/mL, 1 mLSolution0.57
OxymorphoneIV/IM1.5 ...

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