How Often Should Pain Medications Be Taken?

Preventing side effects and accidental overdose

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When you're on painkillers, you may wonder how often you should take them. These drugs are intended to help people recovering from temporary pain like that from surgery or an injury as well as those with chronic pain from cancer or other sources. They can include over-the-counter pain relievers, prescription anti-inflammatories, narcotic (opioid) painkillers, or some combination of these.

So if you're not in pain, can you skip a dose? If you're in constant pain, can you take more or take it more often?

Close-up of woman holding medication pills
Jose Luis Pelaez Inc / Getty Images

The short answer is no, not without approval from your doctor. Dosage schedules are in place to minimize your pain while also protecting you from potentially dangerous side effects or accidental overdose. With narcotics, there's the added risk of addiction.

After surgery, pain medications may also reduce your chances of developing complications such as blood clots or even pneumonia. They can also improve your recovery. Simple acts like walking regularly can help you get better faster, and well-managed pain is important for that.

Pay close attention to instructions regarding whether to take painkillers with food or on an empty stomach. These directions are there to protect you from side effects and ensure your body can use the drug effectively. Your doctor or pharmacist should be able to answer any questions you have.

Before Taking

Before you take any drug for pain, you should know the proper dosage, how long to go between doses, and what potential side effects to watch for. You should also make sure what you're taking won't interact negatively with other drugs or nutritional supplements you're on. Read the packaging information, and if you have any questions, ask your doctor or pharmacist.

While you can find reliable medical information here and elsewhere online, that is general information only. You need instructions that are tailored to your specific situation, including your overall health, age, possibly your sex or weight, other medications you take, allergies, risk factors, and what kind of pain you have.

The goal for you and your doctor should be to use pain medications:

  • At the lowest effective dosage
  • For the shortest amount of time possible
  • Without compromising your recovery

Your doctor may advise you to check your pain level before taking these powerful and potentially dangerous drugs. The table below has recommendations from the American College of Surgeons about making pain-control decisions when you go home after surgery.

 PAIN INTENSITY HOW YOU FEEL RECOMMENDATION
Very mild Pain hardly noticed, activity not limited Non-drug therapies* + non-narcotic drugs as needed
Mild Pain is distracting, simple activities okay Non-drug therapies + non-narcotic drugs as needed
Mild-to-moderate Pain is hard to ignore, more noticeable with rest Non-drug therapies + non-narcotics regularly
Moderate Pain interferes with usual activities Non-drug therapies + non-narcotics regularly
Moderate-to-high Focus is on pain, can't perform daily activities Non-drug therapies + non-narcotics regularly + narcotics (short term)**
High Groaning in pain, can't sleep or do anything Non-drug therapies + non-narcotics regularly + narcotics (short term)
Severe Worst pain possible, nothing else matters Non-drug therapies + non-narcotics regularly + narcotics (short term)

*Non-drug therapies may include:

**Short-term use of narcotics is considered just a few days. If you have severe pain or increasing pain four or more days after surgery, call your surgeon.

Over-the-Counter Medications

You can buy several pain medications over-the-counter (OTC) and your doctor may advise you to use them for pain from a variety of causes. OTC pain relievers include non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen.

NSAIDs

OTC NSAIDs help alleviate pain by lowering your levels of inflammation. They should not be combined with other NSAIDs (either prescription or OTC). OTC anti-inflammatories include:

Your doctor may recommend OTC NSAIDs along with acetaminophen or narcotics.

Acetaminophen

Acetaminophen relieves pain but not inflammation. It's the drug in Tylenol and more than 600 other OTC and prescription medications, including many multi-drug cold and flu products that help alleviate sinus pain, body aches, and fever. It's also in some combination narcotic medications.

Acetaminophen is easier on the stomach than most other pain relievers. It's also generally safe alongside NSAIDs and/or narcotics as well as many other drugs, which is why it's in so many combination products.

BRAND GENERIC MG/FREQUENCY MAX MG/DAY
Advil/Motrin ibuprofen 200-400/4-6 hours 1200
Aleve naproxen 220-440 followed by 220/8-12 hours 660
Aspirin acetylsalicylic acid 325-650/4 hours
975/6 hours
4000
Aspirin-extra strength acetylsalicylic acid 500-1000/4-6 hours 4000
Tylenol acetaminophen 325-650/4-6 hours 4000*
Tylenol-extra strength acetaminophen 500-1000/4-6 hours 4000*
Tylenol-extended release acetaminophen 650-1300/8 hours 4000*
*For long-term use, the maximum recommended daily dose of acetaminophen is 3000 mg.

Acetaminophen Warning

High doses of acetaminophen can be toxic to your liver. If you're taking acetaminophen for pain while also taking other medications, be sure to check all the ingredient lists so you don't accidentally take too much. Acetaminophen is not recommended for people with liver disease or who regularly drink more than a moderate amount of alcohol.

Prescription Anti-Inflammatories

Many prescription NSAIDs are available, including higher strengths of the drugs in OTC NSAIDs, but they still can be prescribed along with narcotics. Dosages may vary between what's recommended for acute (short-term) pain (from surgery or injury) and what's recommended for treating chronic inflammatory diseases, so make sure you follow the instructions from your doctor.

Most prescription NSAIDs are available in multiple strengths. Do not exceed the amount your doctor prescribes. If you feel you need more pain management than the medication provides, contact your doctor and ask about your options.

 BRAND GENERIC MG/FREQUENCY MAX MG/DAY
Celebrex celecoxib 100 2x/day
200 2x/day
400 2x/day
800
Disalcid/Salflex salsalate 750 2x/day 1500
Feldene piroxicam 20 1x/day 20
Indocin indomethacin 50 3x/day 150
Indocin SR* indomethacin 75 2x/day 150
Lodine etodolac 400 2-3x/day 1200
Mobic meloxicam 7.5 1x/day
15 1x/day
15
Motrin ibuprofen 400 2x/day
800 2x/day
1600
Naprosyn/Anaprox naproxen 250 3x/day
500 2-3x/day
1500
Oruvail ketoprofen 75 3x/day 225
Oruvail ER** ketoprofen 200 1x/day 200
Relafen nabumetone 1000 1x/day
1500 1x/day
1500
Voltaren/Cataflam/ Zoroflex diclofenac 50 3x/day
75 2x/day
150
Voltaren/Cataflam XR** diclofenac 100 1x/day 100
*SR=sustained release **ER/XR=extended release

NSAID Warnings

NSAIDs may cause a potentially fatal heart attack or stroke, high blood pressure, kidney or liver failure, ulcers and bleeding in the stomach or intestines, anemia, life-threatening skin reactions, and life-threatening allergic reactions.

Narcotic Painkillers

Narcotics, also called opioids, are synthetic forms of natural opiates such as those found in the opium poppy. Their primary purpose is to treat cancer pain and acute pain, but they're also used extensively to treat chronic pain.

As an epidemic of abuse and overdoses has swept the United States, opioid use has become increasingly controversial. Many people have concerns about taking these drugs, especially for the long term. Doctors are concerned as well, often requiring people with chronic pain to sign contracts promising to take the medications only as prescribed. Federal law limits access to these drugs, as well.

A person's risk of addiction depends on many factors, but research shows it's rare in people who've used narcotics for five days or fewer after surgery. Taking them for longer increases the risk, as does taking higher amounts than prescribed or taking them recreationally. That makes it extremely important to follow your doctor's dosage instructions.

Over time, you can develop a tolerance to narcotics, meaning it takes more to get the same effect. However, it doesn't mean your body can tolerate more without increasing the risk of side effects or overdose. This is part of why it's important to start at and stay at the lowest possible dose at which you get relief.

Some of the stronger narcotics, such as morphine and oxycodone, don't have a maximum daily limit because they're administered around-the-clock for people with unrelenting pain, and at increasingly higher doses. The amount needed and tolerated is highly personal and depends on a multitude of variables.

Some narcotics, and especially combination or extended-release products, do have established daily maximums.

 BRAND INGREDIENTS & MG FREQUENCY MAX MG/DAY
Dilaudid liquid hydromorphone 2.5-10 3-6 hours --
Dilaudid tablets hydromorphone 2-4 4-6 hours --
MS Contin morphine 1-10mg 4 hours --
OxyContin  oxycodone 5-15 4-6 hours --
OxyContin ER oxycodone 5-15 4-6 hours 288
Percocet/Endocet oxycodone 2.5-10
acetaminophen 325
6 hours 60
4000
Tylenol with Codeine codeine 15-60
acetaminophen 300
4 hours 360
4000
Ultram tramadol 50-100* 4-6 hours 400
Vicodin/Lorcet/Norco hydrocodone 2.5-10
acetaminophen 300-325
4-6 hours 60
4000
*Eventual dose after gradually increasing from a lower starting dose

A Word From Verywell

It's always easier to prevent pain than to treat it. Skipping a dose or waiting until you feel the pain to take your meds could leave you suffering unnecessarily and slow down your recovery. If you think you're overmedicated or undermedicated, or if you're having side effects that bother you, talk to your doctor. They know all of the variables that need to be considered when deciding on your pain-management regimen.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American College of Surgeons. Safe and effective pain control after surgery. Published 2018.

  2. Cleveland Clinic. Pain control after surgery. Updated October 2, 2017.

  3. U.S. Food and Drug Administration. Medication guide for non-steroidal anti-inflammatory drugs (NSAIDs).

  4. Harvard Medical School, Harvard Health Publishing. Acetaminophen safety: Be cautious but not afraid. Updated April 15, 2020.

  5. Harvard Medical School, Harvard Health Publishing. Where to turn for pain relief - acetaminophen or NSAIDs? Updated February 21, 2021.

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