Side effects, drug interactions and what’s the medicine you need

Date published: 24/05/2021

Last reviewed: 30/06/2021

Last updated: 10/06/2021

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Pain is that unpleasant physical feeling that tells you something may be wrong in your body. It can be mild or debilitating, sharp or diffuse, last an instant or be a chronic condition. From the development of pain medicines to “the placebo effect”, modern medical science has sought to understand the mechanisms of pain and discover what substances have an active effect on alleviating pain.

Whatever form it takes, when we’re in pain, we seek relief. But how can you be certain of what you need? Are all pain relief medicines the same? There are so many out there. What is the right type for my specific pain? When managing your own health, including pain, start with a conversation with your healthcare provider.

Over-the-counter pain relief

Hunger, lack of sleep, dehydration and lack of exercise can all bring on head pain and a general feeling of malaise. If you are in good health, before you reach for pain medication for a headache, consider remedies such as eating, drinking water, exercise and rest. Still get that occasional ache or pain? Then an over-the-counter medicine may help. But which does what?

There are a few well known painkillers in use in most countries. Among them

Paracetamol is often the first recommended treatment for mild-to-moderate pain because it’s safe for most people when used as directed. This pain reliever and fever reducer comes in many formulations, including tablets, capsules, in liquid solution. But too much paracetamol can cause liver damage if you overdose. Make sure that you follow the label. Check with your doctor before using this medicine if you regularly drink alcohol, you may need to avoid paracetamol altogether or limit the amount that you take depending on how much alcohol you have consumed.
Diclofenac, Ibuprofen, Naproxen are nonsteroidal anti-inflammatory drugs (NSAIDs). That means they are a treatment for inflammation as well as pain, such as from an injury. Some NSAIDs are available in liquid or pill form for oral ingestion, as suppositories and as topical gels that can be applied to skin. Unless recommended by a doctor, oral NSAID medicines shouldn’t be used for long periods of time because of an increased risk of stomach problems and increased chance of heart attacks and strokes. Check with your doctor before using this medicine if you regularly drink alcohol, you may need to avoid NSAIDs altogether or limit the amount that you take depending on how much alcohol you have consumed.

Aspirin (acetylsalicylic acid) This NSAID relieves pain and also makes it more difficult for blood to clot. It has some of the same side effects as ibuprofen and other NSAID but isn’t considered as effective against pain. Do not give aspirin to people younger than 16 due to risk of Reyes Syndrome.

Some over-the-counter medicines combine these active pain relief ingredients or put them together with other substances/actives such as caffeine and codeine.

Sorting out side effects and drug interactions

Many people have questions about the side effects of pain medications such as paracetamol and how those pain medicines might interact with other drugs. That’s why it’s important to talk to your healthcare provider and pharmacist and tell them about all medication you’re taking. They can assess your needs and current treatments and provide you with the latest information and guidance on how to take needed drugs safely.

They can answer such questions as

Which pain medications are suitable for people with heart conditions?
Can I safely take pain relief medicine when I’m pregnant?
Can I combine painkillers? Will these drugs interfere with another medication I take? Does paracetamol have any side effects?
Should I take this medicine with food? Will food affect how the medicine works? How does alcohol affect how paracetamol works?
Some painkillers contain caffeine. I already drink coffee so why would I need paracetamol with caffeine?
Should I take pain medicine before I get a vaccine shot?
Are there parts of my body where I shouldn’t apply this gel?

Pain medicines and children

Dealing with a child in pain can sometimes leave you feeling helpless. You want to be sure that any painkiller you give a little one is safe. It’s good to get the latest guidance on which medicines, such as paracetamol, are suitable and effective in babies and children and what dosage should they receive.

Whatever’s on your mind, we can put it right

Let’s use it right.

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¹Headache. MedlinePlus U.S. National Library of Medicine. https://medlineplus.gov/headache.html [[Accessed 27 May 21]]

²Headache & Dehydration. Migraine & Headache Australia. https://headacheaustralia.org.au/headachetypes/headache-dehydration/ [[Accessed 27 May 21]]

³Dana Sparks. Home Remedies: Relief from tension-type headaches . Mayo Clinic Aug 2018 https://newsnetwork.mayoclinic.org/discussion/home-remedies-relief-from-tension-type-headaches/ [[Accessed 27 May 21]]

⁴Paracetamol. NHS Inform . April 2021 https://www.nhsinform.scot/tests-and-treatments/medicines-and-medical-aids/types-of-medicine/paracetamol [[Accessed 27 May 21]]

⁵Acetaminophen MedlinePlus U.S. National Library of Medicine. https://medlineplus.gov/druginfo/meds/a681004.html [[Accessed 27 May 21]]

⁶Diclofenac. MedlinePlus U.S. National Library of Medicine. https://medlineplus.gov/druginfo/meds/a689002.html [[Accessed 27 May 21]]

⁷Which painkiller? NHS https://www.nhs.uk/live-well/healthy-body/which-painkiller-to-use/ [[Accessed 27 May 21]]

⁸Thomas Meinertz. Gerinnungshemmung mit ASS (Aspirin). Deutsche Herzstiftung https://www.herzstiftung.de/infos-zu-herzerkrankungen/gerinnungshemmung-und-medikamente/ass-aspirin [[Accessed 27 May 21]]

⁹Which painkiller? NHS https://www.nhs.uk/live-well/healthy-body/which-painkiller-to-use/ [[Accessed 27 May 21]]

¹⁰Which painkiller? NHS https://www.nhs.uk/live-well/healthy-body/which-painkiller-to-use/ [[Accessed 27 May 21]]

¹¹Richard B. Lipton; Walter F. Stewart; Robert E. Ryan . Efficacy and Safety of Acetaminophen, Aspirin, and Caffeine in Alleviating Migraine Headache Pain Three Double-blind, Randomized, Placebo-Controlled Trials Arch Neurol. 1998;55(2):210-217 February 1998. https://jamanetwork.com/journals/jamaneurology/fullarticle/1032899 [[Accessed 27 May

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