Painkillers: Common questions answered

Painkillers

From whether branded tablets work better to taking them during pregnancy, we answer your questions about over-the-counter painkillers.

1. Are there different types of pain?

Yes, pain can be acute or chronic. Acute pain comes on suddenly, resolving once the underlying cause is treated.

Generally, it lasts no longer than six months and is present as a warning to the body, for example, toothache or a sprained ankle.

Chronic pain continues even after the original cause has been treated (or resolved). Chronic pain can last for long periods of time and be difficult to manage. An example would be leg pain following a deep vein thrombosis (DVT), or rheumatic pain following a fracture or other injury.

2. Do non-branded painkillers work as well as the branded ones (such as Nurofen, Hedex, Anadin etc)?

Yes. All medicines have to be made to a recommended standard using the same amount of active ingredient, therefore the efficacy (how well they work) should be no different.

Some branded medicines contain added active ingredients such as caffeine (see below), but a non-branded equivalent with the same active ingredients would have the same effect. Occasionally the other components of the medicine may differ slightly, but this should not affect the way they work.

3. Do painkillers with added caffeine work better?

The amounts of caffeine added to painkillers are typically similar to a cup of coffee

Caffeine is added to some painkillers, such as paracetamol and ibuprofen, to help them work better. A recent Cochrane review of evidence found that added caffeine had a small but significant effect, amounting to an additional 5-10% of patients achieving a good level of pain relief.

The amounts of caffeine added to painkillers are typically similar to a cup of coffee. If you’re buying a generic painkiller it will usually be labelled as “paracetamol with caffeine” or “ibuprofen with caffeine” whereas with branded painkillers it may not be as obvious from the name, so check the label if you want to know.

4. Can I take painkillers when I’m pregnant?

Paracetamol is usually safe to take during pregnancy, and is usually the preferred painkiller for treating mild to moderate pain during pregnancy.

Tablets that combine paracetamol and caffeine are not recommended during pregnancy. If you have any concerns, speak to your GP or pharmacist.

5. Can I take painkillers on an empty stomach?

Ibuprofen, aspirin and other NSAIDs (non-steroidal anti-inflammatory drugs) can irritate the stomach lining, so it is best to take them with food, or a glass of milk. Paracetamol doesn’t irritate the stomach lining so it won’t matter if you haven’t eaten.

6. I’m taking painkillers regularly, can I get them on prescription?

If you’re taking regular over-the-counter pain relief, see your GP to make sure you are on the best treatment and not in any danger of any adverse effects. This is vital if you have been taking them for an acute problem for 48 hours or more and the pain remains.

All painkillers are available on prescription, although it is up to your GP to determine if that is appropriate for you.

7. I’ve been taking painkillers for more than six months, is this too long?

Never take more than the recommended or prescribed dose, as this can be dangerous

Painkillers are generally safe if taken as intended, and it’s sometimes necessary to take them for prolonged periods, especially if you have chronic pain.

Never take more than the recommended or prescribed dose, as this can be dangerous. For example, an overdose of paracetamol can cause liver damage.

8. I’ve got ongoing pain – are there other ways to help apart from painkillers?

For mild to moderate chronic pain, have a chat with your GP about other ways to help you handle it, such as going on a pain management course or speaking to a counsellor or clinical psychologist.

If severe pain is affecting your quality of life, ask about a referral to a specialist pain clinic.

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