Taking painkillersPainkiller questions

Taking the right painkillers

What causes pain in the body and how do painkillers work to prevent it?

If your body is injured, enzymes produce chemicals called prostaglandins. These transmit pain signals to your brain and cause inflammation in the injured area.

Inflammation is the body's response to an injury, such as a sprain, and causes the area to become red, swollen and painful. Often the inflammation can result in a loss of function, as with a sprained ankle. Painkillers reduce pain in different ways. Some target the site of the pain; others reduce its sensation.

Are gels that you apply to the skin to treat aches as effective as those you swallow?

Gel painkillers, such as ibuprofen gel, are as effective as tablets in treating acute sprains and can cause fewer gastrointestinal side effects. But research has shown that for the treatment of long-term pain, such as arthritis, oral painkillers relieve pain more effectively.

Is it harmful to take paracetamol, aspirin, ibuprofen or codeine with alcohol?

If you drink moderate amounts of alcohol (14 units a week for women and 21 units for men), you shouldn't experience serious problems when taking painkillers, although codeine can make you sleepy, and alcohol can increase this effect.

Unless you have a damaged liver, taking recommended doses of paracetamol with alcohol shouldn't cause a problem. But alcohol can exacerbate existing stomach problems caused by taking aspirin or ibuprofen, particularly if you are taking them regularly over a long period.

Can I take painkillers after drinking alcohol but before bed to help prevent a hangover?

Painkillers won't help prevent a hangover. Painkillers work by blocking pain for a short time, so you won't feel any effect when you're asleep. Ibuprofen and aspirin may irritate your stomach, so you could feel worse in the morning. But painkillers can help to relieve a headache the next morning. Drinking plenty of water before going to bed will definitely help.

Some painkillers market themselves as 'extra', but are they any better than ordinary painkillers?

There's no established meaning of 'extra'. For example, Anadin Extra contains aspirin, paracetamol and caffeine, Panadol Extra contains codeine and paracetamol, and Hedex Extra is a combination of paracetamol and caffeine.

The published evidence suggests that the 'extra' formulations are no more likely to work than paracetamol alone. Our advice is to keep it simple, and to take either paracetamol or ibuprofen as single drugs.

I've seen painkillers with added caffeine. What does this do?

Some pain relief products contain the active ingredients in combination with caffeine. For example, Anadin Extra includes paracetamol, aspirin and caffeine. Manufacturers claim that the caffeine can help restrict blood vessels and increase the effectiveness of the painkiller, but the evidence is by no means definitive. Caffeine can help make you feel a bit perkier, though.

Does it matter if I use painkillers after the expiry date?

Experts say you should not take medicines past their use-by date. If you do so in error, painkillers are unlikely to be harmful but may be less effective.

Do liquid or powder painkillers relieve pain faster than solid tablets?

Yes, a little. Painkillers have to dissolve in the stomach and need to be absorbed by the body to work. Liquid and soluble painkillers may do this more quickly than non-soluble tablets.

But bear in mind that soluble tablets contain sodium (up to 0.4g per tablet). If you take eight tablets a day, you could get half your maximum recommended dietary allowance of 6g of salt just from the painkillers.

Warning

The advice here is for guidance only. Ask your GP or pharmacist for professional advice about your condition. Painkillers can cause adverse reactions in some people, and you should be particularly careful if you're asthmatic. Opioid painkillers can be addictive so prolonged use should be avoided.

Just tackling the pain does not tackle the underlying cause so if symptoms persist, you should consult your GP. Never exceed the stated dose.