How Often Should Pain Medications Be Taken?

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 healthcare provider. 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 healthcare provider 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 healthcare provider 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 practitioner should be to use pain medications:

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

Your healthcare provider 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:

Rest
Ice
Elevation
Meditation or guided imagery
Acupuncture
Massage
Physical or occupational therapy
Mild exercise (e.g., stretching, walking)

**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 healthcare provider 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:

Advil/Motrin (ibuprofen)
Aleve (naproxen)
Aspirin (acetylsalicylic acid)

Your healthcare provider 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 to 400 mg every 4 to 6 hours	1200 mg
Aleve	naproxen	220 to 440 mg followed by 220 mg every 8 to 12 hours	660 mg
Aspirin	acetylsalicylic acid	325 to 650 mg every 4 hours or 975 mg every 6 hours	4000 mg
Aspirin-extra strength	acetylsalicylic acid	500 to 1000 mg every 4 to 6 hours	4000 mg
Tylenol	acetaminophen	325 to 650 mg every 4 to 6 hours	4000* mg
Tylenol-extra strength	acetaminophen	500 to 1000 mg every 4 to 6 hours	4000* mg
Tylenol-extended release	acetaminophen	650 to 1300 mg every 8 hours	4000* mg

*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 healthcare provider.

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

BRAND	GENERIC	MG/FREQUENCY	MAX MG/DAY
Celebrex	celecoxib	100 mg every 12 hours or 200 mg once daily	400 mg
Feldene	piroxicam	10 to 20 mg once daily	20 mg
Indocin	indomethacin	25 to 50 mg every 8 to 12 hours	150 mg
Indomethacin ER*	indomethacin	75 mg every 8 to 12 hours	200 mg
Etodolac	etodolac	200 to 400 mg every 6 to 8 hours	1000 mg
Mobic	meloxicam	7.5 to 15 mg once daily (tablet) or 5 to 10 mg once daily (capsule)	15 mg (tablet) 10 mg (capsule)
Motrin IB	ibuprofen	400 mg every 4 to 6 hours or 600 to 800 mg every 6 to 8 hours	3200 mg for acute pain or 2400 mg for chronic pain
Naprosyn	naproxen	250 to 500 mg every 12 hours or 250 mg every 6 to 8 hours	1250 mg for acute pain or 1000 mg for chronic pain, increasing to 1500 during a flare
Ketoprofen	ketoprofen	50 mg every 6 hours or 75 mg every 8 hours	300 mg
Ketoprofen ER*	ketoprofen	200 mg once daily	200 mg
Nabumetone	nabumetone	1000 once to twice daily	2000 mg
Cataflam	diclofenac	50 mg every 8 to 12 hours	150 mg
Diclofenac ER*	diclofenac	100 once to twice daily	200 mg

*ER=extended release

Prescription NSAID dosages are based on the condition and type of pain the medication is intended to treat. The dosages listed above are ranges, not suggestions. Always follow your healthcare provider's instructions when taking these medications.

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. Healthcare providers 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.

Public Health

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 healthcare provider'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.

When an opioid overdose is suspected, naloxone hydrochloride should be administered as soon as possible. Naloxone hydrochloride nasal spray is currently available under different brand names, including Kloxxado (8 mg/spray), Rextovy (4 mg/spray), and Rezenopy (10 mg/spray), which are available by prescription, and Narcan (4 mg/spray) and ReVive (3 mg/spray), which are available OTC.

It is very important to take narcotic painkillers under the guidance of a healthcare provider. Taking too much of these drugs or combining them with other medications or alcohol is dangerous and can be life-threatening. Do not depend on the information below to determine the correct dose for your condition. Individual patient needs can vary considerably; always follow your healthcare provider's instructions.

BRAND	INGREDIENTS & MG	FREQUENCY	MAX MG/DAY
Dilaudid liquid	hydromorphone 2.5 mL to 10 mL	3 to 6 hours	--
Dilaudid tablets	hydromorphone 2 to 4 mg	4 to 6 hours	--
MS Contin	morphine sulfate 15 to 60 mg	Patient-specific	--
OxyContin	oxycodone 10 to 40 mg	Patient-specific	--
oxycodone	oxycodone 5 to 15 mg	4 to 6 hours	--
Xtampza ER	oxycodone 9 to 36 mg	12 hours	288 mg
Percocet	oxycodone 2.5 to 10 mg acetaminophen 325 mg	6 hours	60 mg 4000 mg
Tylenol with Codeine	codeine 15 to 60 mg acetaminophen 300 mg	4 hours	360 mg 4000 mg
tramadol	tramadol 50 to 100 mg	4 to 6 hours	400 mg
hydrocodone /acetaminophen	hydrocodone 2.5 to 10 mg acetaminophen 300 to 325 mg	4 to 6 hours	50 mg 4000 mg

*Eventual dose after gradually increasing from a lower starting dose

Current Trends in Pain Management

Frequently Asked Questions

How can I wean myself off of opioid painkillers?

Work with your healthcare provider. There are recommendations for fast tapering, which reduces the dose by 25% to 50% every few days, and slow tapering, which lowers the dose 10% to 20% every one to three weeks. Trying to wean yourself off opioids without a practitioner’s supervision could result in withdrawal symptoms and complications.

Can I take Tylenol and Advil together?

Yes. There is no interaction between acetaminophen (Tylenol) and ibuprofen (Advil) when taken together. However, some people do get an upset stomach by taking more than one medication at once, so you may want to space the doses out over a few hours. Also, never exceed the recommended dose for each medication.

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 healthcare provider. They know all of the variables that need to be considered when deciding on your pain-management regimen.

18 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.

American College of Surgeons. Safe and effective pain control after surgery.
Cleveland Clinic. Pain control after surgery.
U.S. Food and Drug Administration. Medication guide for non-steroidal anti-inflammatory drugs (NSAIDs).
Harvard Medical School, Harvard Health Publishing. Acetaminophen safety: Be cautious but not afraid.
Harvard Medical School, Harvard Health Publishing. Where to turn for pain relief - acetaminophen or NSAIDs?
Nonsteroidal antiinflammatory drugs (NSAIDs) and acetaminophen (paracetamol): Usual oral dosing for adults with pain or inflammation and selected characteristics. In: UpToDate. UpToDate; 2024.
National Library of Medicine. Indomethacin ER - indomethacin capsule Apotheca, Inc.
Food and Drug Administration. Dilaudid® oral liquid and dilaudid® tablets(hydromorphone hydrochloride) CS-II.
Food and Drug Administration. MS Contin (morphine sulfate controlled-release) Tablets CII.
Food and Drug Administration. OxyContin® package insert.
Food and Drug Administration. Oxycodone: Highlights of prescribing information.
Food and Drug Administration. Xtampza ER: Highlights of prescribing information.
Food and Drug Administration. Percocet.
National Library of Medicine. Label: Acetaminophen and codeine phosphate tablet.
National Library of Medicine. Tramadol HCL- tramadol hcl tablet.
National Library of Medicine. Label: Hydrocodone acetaminophen- hydrocodone, acetaminophen tablet.
Dave VH. A patient’s guide to opioid tapering. Hospital for Special Surgery.
Merry AF, Gibbs RD, Edwards J, et al. Combined acetaminophen and ibuprofen for pain relief after oral surgery in adults: A randomized controlled trial. British Journal of Anaesthesia; 104(1):80-88. 10.1093/bja/aep338

Additional Reading

Endo Pharmaceuticals, Inc. Percocet-oxycodone hydrochloride and acetaminophen tablet.
Johnson & Johnson Consumer Inc: Get Relief Responsibly. Adult NSAID dosage chart.
National Institutes of Health, U.S. National Library of Medicine: DailyMed. Label: Tylenol with codeine - acetaminophen and codeine phosphate tablet.
Prescribers' Digital Reference. Naproxen sodium - drug summary.
U.S. Food and Drug Administration: FDA AccessData. OxyContin ER: Highlights of prescribing information.
U.S. Food and Drug Administration: FDA AccessData. Dilaudid: Highlights of prescribing information.
U.S. Food and Drug Administration: FDA AccessData. Ultram (tramadol hyrochloride tablets.
U.S. Food and Drug Administration: FDA AccessData. Oxycodone hydrochloride capsules.
U.S. Food and Drug Administration. Over-the-counter (OTC) ibuprofen: Cardiovascular safety & consumer use.
UpToDate. Morphine: Drug information.
UpToDate. Oxycodone: Drug information.

By Angela Morrow, RN
Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse.

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