7.1.1 Primary dysmenorrhoea
| Choice | Drug |
|---|
| 1st choice | Ibuprofen tablets 200mg, 400mg |
| Or |
| Naproxen 250mg, 500mg
(Plain tablets, not e/c) |
| 2nd choice | Paracetamol tablets 500mg |
| |
Prescribing Notes
- Prescribe as per NICE CKS: Dysmenorrhoea.
- For optimal effect, regular analgesics should be initiated just before anticipated onset of menstruation.
- If the woman does not wish to conceive, hormonal contraceptives may be considered as alternative first line treatment (see section 7.3.1)since they may prevent the pain of dysmenorrhea.
- Refer if symptoms are severe and not responding to initial treatment within 3-6 months, or where symptoms are deteriorating with time, or if there is doubt about the diagnosis.
Cautions
- Mefenamic acid is not listed as a formulary choice. There are concerns that mefenamic acid is more likely to cause seizures in overdose than other NSAIDs; mefenamic acid has a narrow therapeutic window which increases the risk of accidental overdose.
