From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
For biliary colic, nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for pain management, as they have been shown to be effective in reducing pain and complications, with a significantly lower proportion of participants without complete pain relief compared to placebo 1. The most effective NSAIDs for biliary colic include diclofenac, typically given as 75 mg intramuscularly or 100 mg as a suppository for acute episodes, as well as ketorolac 30 mg IV/IM or ibuprofen 400-800 mg orally every 6-8 hours 2, 3, 4, 5.
- Key benefits of NSAIDs in biliary colic include:
- Reduced pain: NSAIDs have been shown to be effective in reducing pain in biliary colic, with a significantly lower proportion of participants without complete pain relief compared to placebo 1.
- Decreased complications: NSAIDs have also been shown to decrease the frequency of short-term complications, such as mild form of acute cholecystitis, jaundice, cholangitis, and acute pancreatitis 1.
- Potential risks and side effects of NSAIDs in biliary colic include:
- Gastrointestinal irritation
- Renal impairment
- Increased bleeding risk
- Patients with peptic ulcer disease, renal insufficiency, or on anticoagulants should use NSAIDs cautiously.
- Alternative treatments for biliary colic include acetaminophen (1000 mg every 6 hours), which can be used as an alternative if NSAIDs are contraindicated, though it may be less effective 1.
- For severe pain unresponsive to NSAIDs, opioids like morphine may be necessary as rescue medication, but they can potentially worsen biliary spasm by increasing sphincter of Oddi pressure 1.