Painkillers
Painkillers (analgesia) come in several versions which all work a bit differently.
The big 3 groups are:
- Paracetamol
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
- Opiates
Paracetamol
(Panadol, Disprol, Calpol)Cheap, few side-effects, used widely.
NSAIDs
Such as Aspirin, Ibuprofen (Ibuleve, Nurofen, Junifen), Diclofenac (Voltarol), Celecoxib (Celebrex), Rofecoxib (Vioxx), and Etoricoxib (Arcoxia)Fairly cheap, ibuprofen most widely available over the counter.
This group has anti-inflammatory properties as well, but these only really start to take effect if the maximum dose is taken for several days in a row, and take a week to reach their full effect.
They all cause inflammation of the stomach lining (less so with the expensive 'Cox'-ones). This inflammation is not normally a problem if only a few days or doses are taken, but if used for longer periods, or in particularly sensitive patients this can be troublesome. If this is the case, symptoms similar to acid-indigestion develop and the drug should probably be stopped.
Asthma: some asthmatics are sensitive to these medicines (they may precipitate an episode of asthma), but only 10% of asthmatics are, so they may be a useful treatment in many more patients than we may be using them in (if you are fine with 'Nurofen', you'll probably be ok with the rest!).
Aspirin is not currently recommended for children with flu-like illnesses (can extremely rarely cause harm… 400x more people die each year struck by lightning, than die from Reye's syndrome!)
Opiates
Such as Codeine (also available with Paracetamol in combination - CO-CODAMOL, eg. Solpadol), Dihydrocodeine (DF118, can also be combined: CO-DYDRAMOL), Morphine (available as a liquid: ORAMORPH, and as a slow release version: MST, and Diamorphine (Heroin… we don't recommend this one!)Great painkilling properties, fairly cheap, but with loads of side-effects to contend with.
As you progress up the list, generally the side-effects get worse. They are: 'wooziness', constipation, nausea, generalised itch, addiction, narrow pupils, and stopping breathing.
Now, these sound fairly awful - but Dr's try to strike a balance with the patient for the benefit of the medicine against the side-effects, and all patients are affected differently by these, so don't despair.
As a good rule of thumb, if you need opiate painkillers, you should agree the dose and regime with your Dr.
Addiction doesn't happen if you need these medicines for only a few days… longer, and do so in discussion with a Dr.
This is one of a number of Patient Information Leaflets available from the Becher's Brook Surgery.