Taking painkillersPainkiller types

Paracetamol

Paracetamol painkillers

What is it? Paracetamol is a non-opioid, so it's non-addictive. It can relieve moderate pain, such as headache and period pain. It also lowers a high temperature, so is used in cold remedies.

How does it work? Scientists believe it works by blocking chemicals in the brain that generate a sensation of pain. It does not act on the site of the pain so it can't reduce inflammation.

Risks? Side effects are rare at recommended doses. It's kinder on the stomach than aspirin and ibuprofen but adults taking more than 4g a day can get liver damage. This risk is increased by heavy alcohol consumption. Don't take it with other treatments, such as cold medicines, that also contain paracetamol.

Children Paracetamol can be given to young children in appropriate doses. It can cause nausea in some young children, but this can be relieved by drinking milk.

Ibuprofen

Ibuprofen painkiller

What is it? Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). It's used for reducing fever and for soothing muscle aches and arthritic pain.

How does it work? It blocks production of pain chemicals at the site of an injury.

Risks? NSAIDs can cause nausea, indigestion and diarrhoea. In some cases they can cause ulcers or stomach bleeding so aren't suitable for people with stomach ulcers or those who develop indigestion-like symptoms while taking them. Older people are at particular risk of the gastrointestinal side effects.

NSAIDs can also trigger asthma, so asthmatics should take care when using the drug. They can also worsen high blood pressure, cause fluid retention and may lead to deterioration in the function of the kidneys. Pregnant women should avoid ibuprofen.

Children A liquid form can be given to children aged from six months.

Aspirin

Aspirin painkillers

What is it? Aspirin is an NSAID and makes the blood less sticky. It's used in low doses on medical advice to thin the blood of people at risk from either strokes or heart attacks.

How does it work? Its anti-inflammatory properties works in the same way as ibuprofen, but it must be used in high doses for this to take effect.

Risks? At the high doses needed to reduce swelling, people may get stomach or bowel bleeding, so it isn't good as an anti-inflammatory painkiller. It should not be taken with other NSAIDs or treatments for high blood pressure without medical advice. Be cautious if you are asthmatic or have an ulcer. Don't take it if you're pregnant or breastfeeding.

Children It's not suitable for the under-16s as it can cause the potentially fatal Reyes syndrome. This begins with cold symptoms, and escalates until the child becomes unconscious.

Codeine

Codeine painkillers

What is it? Codeine, and the related dihydrocodeine, are among the addictive group of drugs called opioids — the same family as morphine.

How does it work? Codeine mimics the body's natural painkillers — endorphins — which block pain receptors in the brain. It can provide additional pain relief if added to another drug in sufficient quantities. But, in general, the amount of codeine or dihydrocodeine in over-the-counter products is too little to make much difference.

Risks? Opioids are addictive so codeine and dihydrocodeine are sold only in small doses. Apart from the risk of dependency, the side effects of all opiates can include nausea and vomiting.

ChildrenCodeine and dihydrocodeine are sold in combination with other painkillers. As the doses will vary, you must check the advice on the packet or ask the pharmacist about their suitability.