Pain Medication Instructions for Adults (age 12+)

 Taking pain medication at the right times and at the right doses is an important part of keeping you comfortable while your mouth heals. Your particular pain medication plan will depend on the extent of your surgery and also your pain tolerance, but these are some general guidelines:

• If you have been given a prescription for pain medication, then pain is expected to be moderate or greater. In many cases, the following 2 medications are prescribed:
  • Ibuprofen 600mg every 6 hours – this prescription may be held or substituted with a different medication in the same class (such as Aleve/naproxen, Toradol/ketorolac, Celebrex/celecoxib)
  • Tramacet (Tylenol with tramadol) every 6 hours – this may occasionally be substituted with Tylenol #3 (Tylenol with codeine), or Percocet (Tylenol with oxycodone), or some others
• A reasonable strategy for most people is to take 600mg ibuprofen as soon as you get home, and take the Tramacet between those ibuprofen doses only if pain is still significant
• OR if pain is fairly well controlled but you’d like some additional pain control, take a plain Tylenol (over the counter) instead of Tylenol #3, between ibuprofen doses (3 hours after a dose of ibuprofen)
• If pain control is inadequate with this combination/dosing, the maximum doses you can take of each medication is:
  • Ibuprofen – 600mg every 5 hours (up to 5 doses of 600mg, or total of 3000mg in 24 hours)
  • Tramacet – two tabs every 4 hours (up to 12 total tablets or 4000mg Tylenol in 24 hours)
• If you’re taking a combination of ibuprofen and Tylenol/Tramacet per the above, it’s usually best to stagger the doses (i.e. take one medication, then 3 hours later take the other one, then 3 hours later take the first one again – making sure you don’t exceed the above maximum daily doses of either one)

• A couple other notes:
  • If you have been prescribed pain medicine with a narcotic (Tramacet, Tylenol #3, codeine, Percocet), DO NOT DRIVE while taking these medications
  • You should not take ibuprofen (or any other NSAIDs) if you have severe kidney disease or are on a blood-thinning medication (such as Coumadin/warfarin, Eliquis/apixaban, Pradaxa/dabigatran, Lixiana/edoxaban, Xarelto/rivaroxaban, Plavix/clopidogrel, Brilinta/ticagrelor)
  • If 600mg ibuprofen tablets are not available at your pharmacy, get over the counter ibuprofen (typically 200mg tablets) and take 3 of them to achieve the same effect
  • If you are taking Tylenol #3 (or any medication with a narcotic), you should avoid alcohol and any recreational drug consumption
  • If you are taking any medication with Tylenol in it, you should avoid concurrent alcohol consumption
  • If you have an allergy to any NSAIDs or Tylenol or any narcotics (codeine, oxycodone, morphine, tramadol, etc.), you may not be able to take some of the above medications
    • If you develop hives or a rash, discontinue the medication and contact our office immediately

If you have any questions – 24 hour on call service – 403-263-5193