Download Pain relief for adults

www.healthinfo.org.nz
Pain relief for adults
There are three main types of pain-relief medicines for adults (age 18 and older): paracetamol,
anti-inflammatories (NSAIDs), and opioid pain relievers.
Paracetamol
Paracetamol is easy to buy from a pharmacy or supermarket,
without prescription. Because it is so common, many people
underestimate how effective it can be. But as long as you take
it at the correct dose it is safe and works well to relieve pain.
The usual dose of paracetamol for adults is two 500 mg
tablets every four to six hours, but no more than eight tablets
over 24 hours. At this dose, paracetamol is safe, but if you
take more it can cause permanent damage to your liver.
Many combination products, such as cold and flu medicines,
contain paracetamol. If you take these at the same time as a
full dose of paracetamol, you may take an overdose.
You can buy small amounts of paracetamol with low-dose codeine, which is an opioid pain
reliever (see below), from a pharmacist. This can help with more severe pain.
Anti-inflammatories (NSAIDs)
Ibuprofen, naproxen, and diclofenac are all non-steroidal anti-inflammatory drugs (usually called
NSAIDs). Although they are often very effective for pain, they do have significant risks and aren't
suitable for everyone to take. They are useful for treating pain and conditions where there is
some inflammation, such as arthritis or muscle sprains.
If you think you need to take an NSAID regularly for more than a week or two, you should tell
your GP. They can assess you to see if you are safe to continue using it, and monitor you for any
problems or side effects. You should not take NSAIDs if you have had a stomach ulcer, problems
with your kidneys, or heart disease.
Important information about blood pressure, heart medication, and anti-inflammatories
If you take an ACE inhibitor or angiotensin receptor blocker (for example Cilazapril, enalapril,
quinapril, losartan, or candesartan) and a diuretic (for example furosemide or
bendroflumethiazide), taking a non-steroidal anti-inflammatory drug (NSAID) could harm your
kidneys. The term for this is "triple whammy". Check with your doctor, practice nurse, or
pharmacist if you aren't sure whether you are taking an ACE inhibitor or angiotensin receptor
blocker and a diuretic.
HealthInfo reference: 370908

Issued: 9 May 2017

Page 1 of 2
Pain relief for adults
www.healthinfo.org.nz
Opioid pain relievers
Codeine, morphine, oxycodone, and tramadol are strong pain relievers that are available only on
prescription, but which can help with more severe pain.
Codeine and tramadol are weaker opioids than morphine and oxycodone.
Opioids are often effective for short-term, severe pain and are useful in palliative care. However,
they have several serious side effects if you use them long-term. Generally they become less
effective if used for longer than seven days, as your body becomes used to them and needs
higher doses for the same effect. This is called tolerance. So it's best to use these medicines for
short-term pain, such as after a major injury, rather than for treating long-term, persistent pain.
Becoming addicted to opioid pain relievers (also called dependence) can be a potential problem,
but it does not happen to most people. People who have had addiction problems in the past are
most at risk of becoming addicted. If you are prescribed an opioid, your GP will need to see you
regularly, so they can monitor how well the medicine is working and keep track of any problems.
Other pain relievers
Other medicines, such as some antidepressants and anti-epileptic medications, can be used to
treat nerve (neuropathic) and persistent pain.
Pain relief and other medicines
Some pain relief can interact with other medicines that you might take. This can cause reactions,
or reduce how well one or other of the medicines work. Always check with a doctor, nurse, or
pharmacist before taking pain relief with other medicines.
Local health professionals recommend the following pages.

Patient – Medication-induced (medication overuse) headache (www.patient.info, search for
“Medication-induced headache)
An explanation of how constant use of pain relief medicines can cause headaches, and what to
do about it.
Written by HealthInfo clinical advisers. May 2017.
370908
HealthInfo reference: 370908

Issued: 9 May 2017

Page 2 of 2