ANALGESICS (PAIN KILLERS)

Pain is, by definition, unpleasant. Listed below are some common preparations used to treat the varying degrees of pain severity.

NSAIDs

- aspirin, ibuprofen, diclofenac

NSAIDs (non-steroidal anti-inflammatory drugs) are most effective at relieving mild pain.

They are particularly effective at relieving muscular pain, dental pain & pain associated with pre-menstrual syndrome (PMS) or rheumatic disease.

Paracetamol

Good for mild pain. Particularly effective for general aches and pains associated with viral infections. Also known as acetaminophen in the USA (eg. Tylenol).

A combination of a NSAID plus paracetamol is very effective for mild to moderate pain.

Codeine

Good for relieving moderate pain. Opioid analgesic.

Some over-the-counter preparations contain a small amount of codeine.

If you require stronger analgesia, a prescription from your doctor will usually be required.

Combination Preparations

- co-codamol (codeine + paracetamol) eg. Kapake, Solpadol, Tylex
- co-dydramol (dihydrocodeine + paracetamol)
- co-proxamol (dextropropoxyphene + paracetamol)

Best for moderate to severe pain. The opioid element in these preparations can cause drowsiness. Long-term use can cause addiction.

Not readily available over-the-counter (ie. prescription-only).

Note: Co-proxamol is to be withdrawn from the market and the CSM has advised that coproxamol treatment should no longer be prescribed; patients who are already receiving it should have their treatment reviewed and another analgesic considered.

Opioids

- dihydrocodeine (DF118)
- tramadol
- fentanyl
- morphine

Best for severe pain. Only available by prescription.

Side-effects of full-dose strength opioids include nausea, vomiting, severe constipation, drowsiness, respiratory depression, and risk of dependence with long-term administration.