Pain relievers and non-steroidal anti-inflammatory drugs you can buy
Some pain relievers and non-steroidal anti-inflammatory drugs can be purchased from pharmacies, shops or supermarkets. It is generally recommended that you manage mild to moderate pain on your own for a short period of time.
These include:
- Painkiller – Paracetamol
- NSAIDs - ibuprofen, aspirin, and diclofenac gel
- Combination analgesics – codamol, paracetamol and ibuprofen, ibuprofen and codeine.
Your healthcare professional may also recommend long-term use of these medications under their supervision to help manage your condition.
Most people can use over-the-counter pain relievers. However, some people may want to be cautious. Seek the advice of a pharmacist or healthcare professional before taking if you have:
- underweight
- Under 16 years old, or over 65 years old
- pregnant or breastfeeding
- Have lung problems, such as asthma
- Have ever had a convulsion or seizure
- Have allergies
- persistent headache
- You have liver or kidney problems
- You have ulcers or bleeding in your stomach
- You have problems with your heart, liver, kidneys, blood pressure, or circulation
- Are taking other medications
- Had a stroke
- Drinking more than 14 units of alcohol per week
- Have a disease that affects connective tissue, such as lupus.
Painkillers containing codeine should only be taken for up to three days without your doctor's advice. Taking other over-the-counter medicines for more than ten days without the guidance of a health care professional may increase the risk of side effects such as stomach, heart, liver, or kidney problems.
If over-the-counter medications don't improve your pain, your doctor may prescribe stronger pain relievers or other types of treatment.
Risks and Side Effects
You should always check the manufacturer's recommendations for guidance on ingredients and how much you can take in a 24-hour period.
Children under 16 should not take aspirin unless prescribed by a doctor because it can cause a condition called Reye's syndrome, which damages the brain and liver and can be fatal.
paracetamol
Acetaminophen is used to reduce fever and help control mild to moderate pain. You can take paracetamol in the form of tablets, capsules, liquid, or tablets dissolved in water. It should start working within an hour and last about five hours.
Although acetaminophen is safe for most people, your doctor may advise against using it if you have other health problems.
If you have low back pain or osteoarthritis, taking acetaminophen alone may not be the most effective treatment.
You can take acetaminophen with a nonsteroidal anti-inflammatory drug, such as ibuprofen or aspirin, or with another pain reliever called codeine.
However, be careful if you are taking medicines for migraines, coughs, colds and flu, or combination pain relievers, as these medicines often already contain paracetamol.
Taking too much paracetamol can cause liver failure.
If acetaminophen doesn't help, a healthcare professional may recommend other treatments, such as an exercise program, physical therapy, or stronger pain relief.
nonsteroidal anti-inflammatory drugs
NSAIDs, or NSAIDs, are recommended for short-term relief of pain, fever, swelling, or stiffness around bones and joints.
You should feel some relief within an hour of using NSAIDs, but it may take days or weeks to feel the full benefits.
If you have been using over-the-counter nonsteroidal anti-inflammatory drugs, such as ibuprofen or aspirin, your doctor may recommend that you continue taking them as directed by them before considering other treatments.
These medications may cause side effects, especially if you take them for a long time. You may be prescribed a short course of the lowest possible dose of non-steroidal anti-inflammatory drugs to treat your pain.
There are approximately 20 types of NSAIDs commonly prescribed, including:
- Ibuprofen
- ketoprofen
- fenbufen
- piroxicam
- aspirin
- naproxen
- Diclofenac
- Indomethacin
- Celecoxib
- etoricoxib
They can be viewed as:
- Tablets or capsules that you swallow
- the liquid you drink
- suppository, a medicine placed on the buttocks
- Creams, gels, sprays, plasters, or mousses that are applied to the skin—called topical nonsteroidal anti-inflammatory drugs.
Your doctor should discuss with you the type of NSAIDs that are best for you, and they should schedule regular check-ups to check your progress.
Nonsteroidal anti-inflammatory drugs may not be suitable for everyone. The type of NSAID you are prescribed may depend on other health problems, such as whether you:
- Over 65 years old
- You may be pregnant or breastfeeding
- Have asthma or allergies
- responsive to NSAIDs
- You have ulcers or bleeding in your stomach
- You have problems with your heart, liver, kidneys, blood pressure, or circulation
- Are taking other medications
- Had a stroke
- You have stomach or intestinal problems, such as ulcerative colitis or Crohn's disease
- your blood pressure, circulation or bleeding problems
- Have a disease that affects connective tissue, such as lupus
- Experiencing persistent headaches.
Depending on what's causing the pain, your doctor may first recommend trying topical nonsteroidal anti-inflammatory drugs, such as ibuprofen, ketoprofen, bifenac, and piroxicam, because they cause fewer side effects than pills.
They are often recommended for treating pain and inflammation in isolated areas caused by osteoarthritis, especially the hands and knees.
Topical nonsteroidal anti-inflammatory drugs may not be helpful for people with inflammation (such as rheumatoid arthritis) because their pain is more widespread. Rheumatoid Arthritis >
However, nonsteroidal anti-inflammatory drugs are considered the most effective way to relieve the pain and inflammation caused by rheumatoid arthritis.
Nonsteroidal anti-inflammatory drugs can cause stomach problems, so your doctor may prescribe a drug called a proton pump inhibitor (PPI), such as omeprazole or lansoprazole, to reduce the amount of stomach acid.
Some NSAIDs (e.g., celecoxib, etoricoxib) are designed to be gentle on the stomach.
Depending on your condition, other medications may be prescribed, such as disease-modifying antirheumatic drugs (DMARDs) or steroids. These medications can help relieve pain by treating the condition that causes the pain.
If you are taking acetaminophen, you may use nonsteroidal anti-inflammatory drugs. However, you should be careful about taking NSAIDs with combination pain relievers because some combination pain relievers contain NSAIDs.
If you have concerns about taking NSAIDs, seek the advice of your healthcare professional.
Risks and Side Effects
If you are taking anticoagulant medications to thin the blood, such as low-dose aspirin or warfarin, it is best to avoid taking other nonsteroidal anti-inflammatory drugs or combination pain relievers.
Even low doses of NSAIDs can cause side effects such as:
- Headache
- Dizziness
- Stomach pain, illness, diarrhea and indigestion
- bleeding
- swollen ankles
- Having trouble peeing
- Chest pain and difficulty breathing
- Rash or sensitivity to sunlight.
If you experience any side effects, stop taking your pain medication and consult your doctor.
Long-term use of nonsteroidal anti-inflammatory drugs can cause problems with the liver, kidneys, heart, and blood circulation.
Nonsteroidal anti-inflammatory drugs can cause stomach problems and are best taken with food or milk to help reduce these side effects.
If you are over 65, certain nonsteroidal anti-inflammatory drugs can increase your risk of stomach ulcers. Talk to your doctor if you are at risk for stomach problems or have stomach pain after taking NSAIDs.
Nonsteroidal anti-inflammatory drugs may cause side effects, and long-term use should be monitored by a health care professional.
compound analgesics
Combination pain relievers combine two pain medications.
Some combination pain relievers are available over the counter from a pharmacist, others can only be prescribed by a health care professional.
For example:
- Coconut oil-based Damol, which contains low doses of codeine and paracetamol, is available over the counter
- Paracetamol and ibuprofen tablets, available over the counter
- Ibuprofen and codeine, available over the counter
- Dederamol, a combination of paracetamol and dihydrocodeine, is available by prescription
- Cocordaprine, which contains codeine and aspirin, is available with a prescription.
Depending on what's causing your pain, your doctor may recommend that you try acetaminophen and a nonsteroidal anti-inflammatory drug before prescribing a combination pain reliever.
Combination pain relievers can be taken as tablets, capsules, or dissolved in water.
Healthcare professionals are unlikely to prescribe combination pain relievers containing the opioids codeine and dihydrocodeine for more than a few days because there is little evidence that they help with long-term pain.
If you are taking combination pain relievers and are still experiencing pain, talk to your doctor.
To avoid accidentally taking too much medicine, make sure you know what ingredients your combination pain relievers contain and avoid them when taking them.
Because each ingredient can cause different side effects, combined pain relievers may increase your risk of adverse reactions.
Risks and Side Effects
Combination pain relievers can relieve your pain, but they may cause more side effects.
Combination pain relievers containing aspirin, acetaminophen, or ibuprofen carry the same risk of side effects as taking these medications alone.
Common side effects of combination pain relievers include:
- Nausea
- drowsiness
- feeling dizzy
- heartburn or indigestion
- constipate.
People who take painkillers containing opioids may develop dependence if they take them for a long time.
If you are pregnant or breastfeeding, seek your doctor's advice before using combination pain relievers.
antidepressants
Low-dose antidepressant medications may be prescribed to treat long-term persistent pain.
These drugs were originally developed to treat anxiety and depression. However, when taken at lower doses, they have been found to be effective in treating pain. Physicians are now encouraged to prescribe low-dose antidepressants before other pain-relieving treatments.
If you take antidepressants, they can improve your body's response to pain, mood, emotional state, and sleep quality.
Antidepressant medications commonly recommended for treating pain include:
- Amitriptyline
- citalopram
- B
- fluoxetine
- Paroxetine
- Sertraline.
These medications may not be suitable for everyone. Because they are not originally designed to treat pain, your doctor may first want to discuss the benefits and risks of prescribing them before deciding whether antidepressants may help your condition.
Antidepressant medications may affect other conditions, including:
- diabetes
- epilepsy
- heart problems
- glaucoma
- overactive thyroid
- Severe liver disease.
Risks and Side Effects
Many people take antidepressant medications without any problems, but they may cause some side effects. Many of the more common illnesses will go away once your body adjusts to them.
Side effects include:
- constipate
- Dizziness
- dry mouth
- feeling sleepy
- blurred vision
- Difficulty urinating
- Headache.
If these side effects do not improve, talk to your doctor or pharmacist.
Sometimes people experience weakness on one side of their body or have difficulty speaking, thinking, or balancing. If you experience these side effects, seek urgent medical advice.
Some people also experience changes in appetite and weight when they start taking antidepressants, so talk to your doctor if you're concerned about this.
Some antidepressant medications can make you drowsy. It is recommended that you avoid riding a bicycle, driving a car, or using machinery during the first few days of taking these medications until you know how they affect you.
Nefopam
Nefopam is a non-opioid pain reliever that can be prescribed to treat pain if non-steroidal anti-inflammatory drugs and acetaminophen don't help.
It causes fewer breathing problems than opioids. Acetaminophen or nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen) may sometimes be used as additional ways to control pain.
However, it has not been proven to be of great benefit to people with chronic pain and may cause some side effects.
Risks and Side Effects
Nefopam may cause side effects, including:
- nausea
- nervous
- confusion or seeing things that are not there
- Numbness and tingling in the hands or feet
- Having trouble peeing
- dry mouth
- Dizziness.
You may not be able to take nefopam if you:
- Have epilepsy or have had a seizure before
- Have liver or kidney problems
- Having trouble peeing
- Suffering from angle-closure glaucoma.
If you are over 65, you may be more likely to be confused or see things that aren't there. Nefopam is generally not recommended for use during pregnancy.
Opioid pain relievers and pain relief patches
Opioid pain relievers may be prescribed to relieve moderate to severe pain when other forms of pain relief fail.
Some opioids are stronger than others. If your doctor thinks your pain can only be relieved by opioids, they will prescribe the lowest dose for the shortest possible time. Opioids come in tablet, liquid, or patch form.
However, due to the risk of side effects such as addiction and overdose, health care professionals are advised to avoid prescribing opioid painkillers to treat long-term pain whenever possible. If you take opioid pain relievers, your treatment should be carefully monitored.
If you think your pain relievers are not helping your symptoms or are causing unpleasant side effects, it may be a good idea to reduce or stop taking them. Talk to your doctor about how to minimize the risk of any withdrawal symptoms. This may include gradually reducing your dose and having regular reviews with your healthcare team.
Opioid pain relievers include:
- codeine
- dihydrocodeine
- Tramadol
- Buprenorphine
- Fentanyl
- morphine
- diamorphine
- Oxycodone
- He Pentadol.
The low-dose codeine used in combination painkillers is the only opioid painkiller available without a prescription.
opioid patch
If you have tried low-dose opioids (such as morphine) and are still experiencing pain, your doctor may consider prescribing an opioid patch.
These patches usually contain buprenorphine or fentanyl, which is slowly released into the body over several days. For guidance on how often you should change your patch, see the patient information leaflet included in the package.
Only wear one patch at a time unless your doctor tells you otherwise.
You should keep the area where the patch is applied away from any sources of heat, such as hot water bottles, electric blankets or heating pads, or sunlight. This is because heat can cause too much medication to be released into the bloodstream too quickly.
You should tell any health care professional treating you that you are using opioid patches because they can interact with other medications.
Risks and Side Effects
Opioid pain relievers often cause more side effects than other pain relievers and require careful monitoring by a doctor.
Risks and side effects of opioid pain relievers include:
- feeling or sick
- toilet problems
- itching
- Drowsiness and dizziness
- unable to concentrate
- Low libido, decreased fertility, and erectile dysfunction
- Fighting infection is more difficult
- increased pain
- Breathing problems.
Some side effects will lessen during treatment. If you are concerned, talk to your doctor.
If you have breathing problems such as sleep apnea, asthma, or chronic obstructive pulmonary disease (COPD), talk to your doctor before taking opioid pain relievers.
Taking opioids with sedatives (such as diazepam, temazepam, or alcohol) may make you more likely to feel drowsy, dizzy, and unable to concentrate.
Opioids can cause seizures. If you are taking antipsychotics or antidepressants, you may be more likely to have seizures if you take the opioid tapentadol.
Opioid pain relievers can be addictive and should be used with caution. If you feel your doctor is not following the dosage prescribed or you are still experiencing pain after completing a course of opioid pain relievers, talk to your doctor.
Your doctor may recommend that you stop taking opioids. Depending on how long you take it, you may experience some reactions, including:
- Tremors or muscle spasms
- Anxiety, sweating, or irritability
- Illness, diarrhea, or stomach cramps.
If you have been taking opioid pain relievers for a long time, you should only stop taking them under the guidance of a health care professional, as stopping treatment suddenly can be dangerous.
Effects of analgesics and nonsteroidal anti-inflammatory drugs on other treatments
Many people with arthritis and related conditions need to take pain relievers or non-steroidal anti-inflammatory drugs, as well as medications to treat their underlying causes. The combination you take and how long you take them depends on your condition.
For inflammatory types of arthritis, such as rheumatoid arthritis, your doctor should recommend starting treatment with a disease-modifying antirheumatic drug (DMARD), such as methotrexate.
DMARDs won't stop your pain immediately, but you should be able to reduce or stop taking pain medications once they start to take effect.
If you have gout, you may take the anti-inflammatory drug colchicine or a nonsteroidal anti-inflammatory drug to relieve pain and swelling attacks. Aspirin may make gout worse. You may need to take other medications, such as allopurinol or febuxostat, to reduce your risk of gout attacks in the long term.
If you have osteoarthritis in your hands or knees, you can treat the affected joints with capsaicin cream several times a day, along with taking painkillers.
If you are taking medications for other medical conditions, you should ask your doctor or pharmacist about possible interactions.
Complementary treatment
Complementary treatments, such as herbs, vitamins, and supplements, are tested differently than pain relievers and nonsteroidal anti-inflammatory drugs, so it's difficult to say whether they are safe to take together.< /span>
You should always tell the health care professional treating you about any other medications you are taking, including complementary treatments, herbs, vitamins, or supplements, before starting a prescription medication.
Alcohol
Most people who take pain relievers or non-steroidal anti-inflammatory drugs can drink alcohol in moderation.
Alcohol increases the risk of side effects from certain pain relievers and nonsteroidal anti-inflammatory drugs. It is best to read the leaflet that comes with your medicine to find out what it says about drinking alcohol.
If you are new to taking opioid pain relievers, or if your dose is increased, it is recommended that you avoid drinking alcohol until you decide to take the medication. Alcohol and opioid pain relievers can affect your concentration and make you feel sleepy.
If you are driving or using machinery, it is recommended that you avoid alcohol.
It's best to stick to government guidance of no more than 14 units of alcohol per week and spread your drinking out over the week. It will be good for you to go two or three days a week without drinking alcohol.
If you have any questions, ask your doctor or pharmacist.
Fertility, pregnancy and breastfeeding
If you are planning to start a family or you are pregnant, you should discuss your medication with your doctor as soon as possible.
Paracetamol is often the recommended pain relief option if you are pregnant or breastfeeding, but it is best to discuss any medication with your healthcare professional.
It is generally not recommended to use NSAIDs during pregnancy, especially after 30 weeks, unless your doctor advises you to take them.
In rare cases, low-dose aspirin can be continued during pregnancy, but only in serious cases should you receive specialist care, including:
- hypertension
- Certain other long-term conditions - such as lupus.
Nonsteroidal anti-inflammatory drugs are considered safe to take if you are breastfeeding.
Low-dose antidepressant medications are considered safe during pregnancy.
Paracetamol and opioid painkillers can be used during pregnancy, but they are not recommended for regular or long-term use.
Taking opioids during pregnancy increases your baby's risk of breathing problems, experiencing withdrawal pain, and may affect their future brain function. They should only be taken under the guidance of a doctor.
Some low-dose opioids (such as dihydrocodeine) are considered safe if you are breastfeeding, but you should avoid any medicines that contain codeine.
If you are pregnant and have been taking opioids every day for a period of time, you should not suddenly stop using them without talking to your doctor.
Stopping opioids without the help of a doctor or midwife can be dangerous to yourself and your baby, especially in the first trimester when it can lead to miscarriage, and in the last trimester when it can increase complications in labor risk of disease and stillbirth.
