Dysmenorrhea
Clinical basis & sources
- Primary source
- OCP Minor Ailments Prescribing
Sources used
- Ontario Regulation 256/24: GeneralGovernment of Ontario · 2026
- Minor Ailments: Drug Classes and Specified DrugsOntario College of Pharmacists · 2026
- Executive Officer Notice: Update to Funding for Minor Ailment Services in Ontario Pharmacies (Effective July 1, 2026)Government of Ontario · 2026-05-19
- DysmenorrheaAmerican Family Physician · 2021
- DysmenorrheaMerck Manual Professional Edition · 2025
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Allowable drugs under Schedule 4 (8)
Drugs an Ontario pharmacist may prescribe for Dysmenorrhea under O. Reg. 256/24, Schedule 4. Choice still depends on the assessment, contraindications, allergies, and product availability — this is the eligible list, not a recommendation.
- Acetylsalicylic acid (ASA)
- Celecoxib
- Diclofenac
- Flurbiprofen
- Ibuprofen
- Ketoprofen
- Mefenamic acid
- Naproxen
Symptoms this assessment screens
- Crampy lower abdominal or pelvic pain linked to menses
- Predictable pattern starting just before or with menstrual flow
- Pain may radiate to back or thighs
- Nausea, vomiting, diarrhea, headache, dizziness, or fatigue with menses
- School, work, sleep, or daily function affected
- Prior response to NSAIDs, heat, or self-care
Red flags — any positive means refer
- Pregnancy possible, late or missed period, positive test, or ectopic pregnancy concern
- Sudden severe pelvic or abdominal pain, syncope, shoulder-tip pain, or unstable patient
- Fever, abnormal vaginal discharge, pelvic infection concern, or systemic illness
- Heavy, prolonged, intermenstrual, or postcoital bleeding
- New or worsening pain after age 25, non-cyclic pain, dyspareunia, infertility, or suspected secondary cause
- Possible IUD complication, postpartum/recent pelvic procedure, sexual assault, or safety concern
- NSAID allergy, active ulcer/GI bleed, severe kidney disease, anticoagulation, uncontrolled hypertension, or late pregnancy
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