There is such an immense array of over the counter painkillers that selecting one can be bewildering. When you stand at the pharmacy counter, the aisle in the supermarket or even the gas station, and reach for a packet are you making an informed decision? Here are the basics that everyone should know about over the counter painkillers.
Most over the counter painkillers fall into one of three types:
Non-opioid -These are drugs that do not contain opium extracts – the main one is paracetamol
NSAIDS - Non-steroidal anti-inflammatory drugs, such as ibuprofen and aspirin are useful for tackling the pain associated with inflammation such as that experienced with arthritis or muscle sprain.
Mild opioids -These do contain some form of an opiate e.g. codeine
It is safe to use a non-opioid/opiod at the same time as a NSAID; e.g. paracetamol with ibuprofen.
These drugs may appear under various brand names and will differ between countries.
No license is required for a retailer to sell OTC painkillers which is why you will find in all sorts of convenient places. Some countries however, have legislation limiting the number you can buy without prescription.
Over the counter painkillers are available without a prescription from a doctor. They are available on the basis that they are a dose sufficient enough to provide mild to moderate pain relief. OTC painkillers can be used for a variety of the most common aches and pains including headaches, toothaches and period pain. Non-prescription drugs also come in a wide variety of forms that are designed to relieve the symptoms of infections such as colds and flu. You may also find examples of drugs that are mainly available on prescription but they will be in greatly reduced dosages compared to the ones you get from the doctor.
Painkillers work on the chemicals known as prostaglandins which are part of the defenses in your body’s immune system. Prostaglandins are responsible for pain, high temperatures of a fever and inflammation. Basically when Prostaglandins in your never cells detect inflammation or damage, they send pain signals to your brain. NSAIDS work by blocking the production of an enzyme called cyclooxygenase which helps to produce prostaglandins. With a reduced number of prostaglandins, there are fewer signals sent to the brain and hence, fever, pain or inflammation is reduced. Paracetamol works in the same way, but without the anti-inflammatory properties. Aspirin is too, slightly different; as well as blocking pain, it also has other effects such as the prevention of blood clots.
Over the counter painkillers come in various forms – designed that pretty much anyone should be able to find a way to use them they are comfortable with: different shaped tablets, capsules, dissolvable powders or tablets, liquids, gels, creams and patches.
Whatever your drug of choice and the form it takes, it is VITAL you read the instruction leaflet about dosage and frequency and also read the contraindications – especially if you are taking other medicines and supplements. NEVER exceed the recommended dosage. If you think the dosage isn’t enough, mix paracetamol with ibuprofen rather than double the dose of one.
Following on from the last point, it is surprisingly easy to find that you are taking too many painkillers at once. Painkillers may be present in medicines you are taking for symptoms you might not consider as needing pain relief. For example, if you are taking a decongestant because you have a cold or a pastille to relieve a sore throat. You need to read the ingredients of these kinds of medicines to be sure of not overdosing. For example: Many of the general cold ease preparations will contain paracetamol, so even if a headache is one of the symptoms of your cold, do not take a cold relief tablet and a dose of paracetamol.
Popping a paracetamol – such as Tylenol or Panadol, every time you have a headache or feel a bit achy, may sound pretty harmless – they are available over the counter, so they can’t be dangerous can they – but it is at the end of the day a drug. The main active ingredient in paracetamol and cold relief preparations is acetaminophen. This is known to cause liver damage, so while taking a few paracetamol every day may be helping your aches and pains, you are also causing long term damage elsewhere.
There won’t be side effects from most over the counter painkillers if you use them occasionally and as directed for dosage and frequency. Some NSAIDs however, might be used for longer periods of time and there are some things to watch out for as NSAIDs can take their toll on the stomach, causing nausea, vomiting, tummy ache, indigestion and diarrhea. At their worst, they can cause bleeding from the stomach so if you vomit blood of see blood in your feces you need to contact your doctor.
The general rule for over the counter painkillers is common sense. Read the instructions, take as recommended, make sure you are taking the right medicine and avoid mixing drugs that contain the same ingredients.
How do you feel about OTC painkillers? Do you use them, avoid them, ignore them or prefer a natural remedy instead?