USUAL DOSE. 300 to 650 mg every 4 hours
and up to 1 g four times daily, not to exceed 4 g
ACTION AND USE. Ibuprofen is indicated
for the relief of mild to moderate pain, including
headaches and menstrual cramps. It is also used
as an anti-inflammatory agent in the treatment
of arthritis, tendinitis, bursitis, etc. It is not
recommended in the third trimester of pregnancy,
gastrointestinal bleeding, or renal impairment.
USUAL DOSE. Do not exceed 2.4 g per
day. For mild to moderate pain, give 400 mg every
4 to 6 hours as needed. For anti-inflammatory use,
give 300 to 600 mg three or four times daily as
needed. It may be taken with food or milk.
Naproxen Sodium (Anaprox)
ACTION AND USE. Naproxen sodium was
developed as an analgesic because it is more
rapidly absorbed than naproxen (Naprosyn), a
non-steroidal anti-inflammatory with analgesic
and antipyretic properties. It is indicated for the
relief of mild to moderate pain and for the treat-
ment of primary dysmenorrhea, rheumatoid ar-
thritis, osteoarthritis, tendinitis and bursitis, and
acute gout. Its effects are similar to aspirin and
indomethacin but with less toxic gastrointestinal
side effects; however, it is not indicated for pa-
tients with a history of gastrointestinal disease,
especially those with a propensity for peptic ulcer
USUAL DOSE. Two tablets initially then
one tablet every 6 to 8 hours as required for mild
to moderate pain but not to exceed 5 tablets daily.
For long term treatment of arthritis, one tablet
twice daily for two to four weeks.
ACTION AND USE. Indomethacin is a po-
tent anti-inflammatory agent with antipyretic and
analgesic properties. Because it may cause side ef-
fects, it should be reserved for cases of chronic
rheumatoid arthritis, osteoarthritis, or acute gout.
USUAL DOSE. 25 to 50 mg two to three
times daily not to exceed 200 mg daily.
Tolmetin Sodium (Tolectin)
ACTION AND USE. Tolmetin sodium has
the same indications, contraindications, and uses
USUAL DOSE. 400 mg three times daily in-
itially, then adjusted to patient response but not
to exceed 2000 mg daily.
ACTION AND USE. Sulindac has the same
indication, contraindication, and uses as indo-
methacin and tolmetin sodium but is longer
USUAL DOSE. 15o to 200 mg twice daily
ACTION AND USE. Along with its anti-
inflammatory properties, phenylbutazone is
regarded as a potent analgesic for relief of the pain
of rheumatoid arthritis and associated condition.
Because of its high incidence of toxic side effects,
it is recommended only for patients who do not
respond to less toxic drugs. It is also used to relieve
the symptoms of acute gouty arthritis when less
conservative measures are not effective.
USUAL DOSE. Initially, 300 to 600 mg
daily in three or four equally divided doses with
food or milk. The dosage is adjusted to the lowest
level to receive favorable results. If favorable
results are not obtained in 7 to 10 days, treatment
with phenylbutazone should be discontinued.
CENTRAL NERVOUS SYSTEM
Certain drugs stimulate the activity of various
portions of the central nervous system (CNS).
Chapter 21 of the Manual of the Medical Depart-
ment (MANMED) is explicit as to the usage of
these drugs in the Navy. Primary indications for
this class of drugs are narcolepsy, hyperkinesis,
and attention deficit disorders in children. Cen-
tral nervous system stimulants are generally con-
traindicated in patients with hypertension,
disorders, agitated states, glaucoma, or history
of drug abuse.