| Drug | Class | Adult | Paediatric | Notes |
|---|---|---|---|---|
| Ibuprofen or naproxen (NSAID)[1] | Cyclooxygenase inhibitor | Ibuprofen 400 mg PO TDS-QDS PRN; naproxen 250–500 mg PO BD PRN | Ibuprofen 7–10 mg/kg/dose | First-line analgesic for LBP and sciatica when pain limits function; lowest effective dose, shortest duration; co-prescribe PPI if risk; avoid in CKD, peptic ulcer, severe HF, anticoagulation |
| Paracetamol (limited evidence in LBP)[1] | Analgesic | 1 g PO QDS PRN, max 4 g/day | 15 mg/kg/dose, max 60 mg/kg/day | Limited evidence in non-specific LBP per recent reviews; useful adjunct or alternative when NSAIDs contraindicated |
| Codeine or weak opioid (selected, short-term)[1] | Weak opioid | Codeine 30–60 mg PO QDS PRN, max 240 mg/day | — | Reserve for moderate-severe acute pain unrelieved by NSAID/paracetamol; short course only; constipation, dependence; avoid for chronic LBP |
| Diazepam or short-acting muscle relaxant (severe spasm)[1] | Benzodiazepine — short-acting | Diazepam 2–10 mg PO BD-TDS for ≤7 days | — | Severe acute muscle spasm; do not use long-term; sedation, dependence; avoid driving |
| Amitriptyline or duloxetine (chronic LBP with neuropathic component)[1] | TCA / SNRI | Amitriptyline 10–25 mg PO night, titrate to 75 mg; duloxetine 30–60 mg PO daily | — | Chronic LBP with neuropathic features; not for acute LBP; specialist initiation; review at 8 weeks |
Risk-stratified assessment, exercise, and multimodal management of low back pain and sciatica in adults ≥16 years.