://module2 The WHO method page 7/9
WHO Ladder Step 2 <<previous next>>
If pain persists or increases, patients move up from step 1 to step 2. They will typically continue on any NSAID / adjuvants already prescribed, but should also be commenced on a weak opioid, such as Codeine, Dihydrocodeine or Tramadol. If they were also on Paracetamol, a combined preparation can be prescribed, being careful not to exceed the maximum recommended dose of Paracetamol of 4g in 24 hours.
The table below shows typical dosages of some commonly used drugs.
| Drug | Dosage | Frequency | Route |
| Codeine phosphate | 30mg - 60mg | 6 hourly | PO |
| Dihydrocodeine | 30mg - 60mg | 6 hourly | PO |
| Cocodamol (30/500) | 1-2 tabs | 6 hourly | PO |
| Codydramol | 1 -2 tabs | 6 hourly | PO |
So a patient on Step 2 may be on a drug regime like this:
Cocodamol (30/500) 2 tabs four times a day
Diclofenac 50mg three times a day
Lansoprazole 15mg once a day
+ / - any adjuvants as needed.