This advice is sourced from Dr Ros Taylor a senior palliative physician
All painkillers have benefits and risks. Some work better for certain types of pain. Therefore it is important to know the cause of the pain.
Do feedback to your doctor how your pain medicine works for you. Side effects can usually be treated effectively.
Please seek medical advice if you have a rapidly changing pain as there may be a treatable cause and medicines will need changing.
This table is a simple overview of the main types of pain medications:
|
Type of pain relief
|
Example |
Use |
Side effects and issues to consider |
|
Paracetamol |
A very effective painkiller used to treat pain and fever |
Paracetamol can improve the effect of other painkillers Doses need reducing in people with liver disease |
|
|
Non steroidal anti inflammatory drugs (NSAIDs) |
Ibuprofen (e.g. Nurofen), Naproxen, Aspirin, Diclofenac, Celecoxib |
Used for pain, inflammation and fever NSAIDs are very effective for certain types of pain e.g. bone pain or pain caused by inflammation due to infection, wounds or cancer |
Can cause irritation or bleeding from the stomach or bowel and often are prescribed with medicines to protect the stomach lining (e.g. omeprazole, lansoprazole) NSAIDs can also affect kidney function and some people find it worsens the wheezing in asthma |
|
Weak Opioids |
Codeine, Co-dydramol, Co-codamol, Tramadol |
These are widely prescribed for moderate pain and are often combined with paracetamol |
Nausea and drowsiness often settle after the first few doses Constipation may need regular laxatives Remember not to take extra paracetamol if on a medicine that combines a weak opioid with paracetamol (e.g. Co-codamol) Please see our information on opioid concerns. |
|
Strong Opioids |
Morphine, Oxycodone, Fentanyl |
Depending on level of pain the right strength opioid in the right dose will be prescribed by your doctor. Opioids can be effective for all types of pain |
Nausea and drowsiness often settle after the first few doses Constipation may need regular laxatives Please see our information on opioid concerns Can be given orally, via a patch on the skin or by injection |
Top Tips
- Certain medications which are not well known as 'painkillers' can be very effective for certain types of pain. For example some antidepressants (e.g. amitriptyline, duloxetine) and some anticonvulsants (e.g. gabapentin, pregabalin) can be effective for nerve pain.
- Anti-spasm medication (e.g. Buscopan) can be used for crampy pain.
- Steroids can be very effective for pains caused by swelling.
- Mouthcare can be very effective for sore mouths.
Cautions
- Liver and kidney function affects what doses you can safely take
- Check with your pharmacist that your combination of painkillers is safe along with other regular medications
- Do not stop pain medications suddenly as this may cause painful withdrawal effects
- Remember some medications already contain paracetamol (e.g. Co-codamol, Co-dydramol)
Marie Curie have comprehensive resources on Pain relief and common side effects.