Painkillers and NSAIDs (2022)

Download painkillers and NSAIDs information booklet

Print this page

What are painkillers and NSAIDs?

Painkillers and NSAIDs, are types of drugs called analgesics, which are used to treat pain.

The greatest difference is that painkillers target the levels of pain you’re feeling, by interrupting pain signals before they get to the brain.

NSAIDs, which can also be called non-steroidal anti-inflammatory drugs, help manage pain and fever, mostly by reducing inflammation.

However, if you have long term pain or inflammation, they are unlikely to improve the underlying problem that’s causing it.

Painkillers and NSAIDs you can buy

Some painkillers and NSAIDs are available to buy from pharmacies, shops, or supermarkets. They are often recommended for managing mild to moderate pain yourself, over a short period of time.

These include:

  • the painkiller - paracetamol
  • NSAIDs – ibuprofen, aspirin, and diclofenac gel
  • compound painkillers – co-codamol, paracetamol and ibuprofen, ibuprofen and codeine.

Your healthcare professional may also recommend using these drugs under their guidance over the long term, to help manage your condition.

Most people can use over-the-counter pain relief. However, some people may need to be cautious. Seek advice from a pharmacist or healthcare professional before taking them if you:

  • are underweight
  • are aged under 16, or over 65
  • are pregnant or breastfeeding
  • have lung problems, such as asthma
  • have ever had fits or seizures
  • have allergies
  • have persistent headaches
  • have problems with your liver or kidneys
  • have had ulcers or bleeding in your stomach
  • have had problems with your heart, liver, kidneys, blood pressure, or circulation
  • are taking other medicines
  • have had a stroke
  • drink more than 14 units of alcohol a week
  • have a condition affecting your connective tissue, such as lupus.

Painkillers containing codeine should only be taken for three days at most without medical advice. Taking other over-the-counter drugs for longer than ten days without guidance from a healthcare professional, could increase your risk of side effects such as problems with your stomach, heart, liver, or kidneys.

If over-the-counter drugs haven’t improved your pain your doctor may prescribe stronger pain medication or another type of treatment.

Risks and side effects

You should always check the manufacturer’s advice for guidance on ingredients and how much you can take over 24 hours.

Children, aged under 16, should not take aspirin unless it’s prescribed by a doctor, as it can cause an illness called Reye’s syndrome, which can damage the brain and liver, and could be fatal.

Paracetamol

Paracetamol is used to reduce fever and can help manage mild to moderate aches and pain. You can take paracetamol as a tablet, capsule, liquid, or as tablets that dissolve in water. It should start working within the hour and last for around five hours.

Though paracetamol is safe for most people, your doctor may advise against using it if you have another health issue.

(Video) High doses of NSAID pain killers bad for the heart says study

If you have problems such as lower back pain, or osteoarthritis, taking paracetamol alone may not be the most effective treatment.

You can take paracetamol with NSAIDs, such as ibuprofen or aspirin, or with another painkiller called codeine.

However, be careful if you’re taking medicines for migraines, coughs, colds and flu, or compound painkillers, because these drugs often already contain paracetamol.

Taking too much paracetamol can cause liver failure.

If paracetamol isn’t helping, a healthcare professional may recommend other treatments, such as a programme of exercise, physiotherapy, or a stronger type of pain relief.

NSAIDs

NSAIDs, or non-steroidal anti-inflammatory drugs, are recommended for short-term relief from pain, fever, and swelling or stiffness around your bones and joints.

You should feel some relief within an hour of using NSAIDs, but it can take several days or weeks before you feel the full benefit.

If you’ve been using over-the-counter NSAIDs, such as ibuprofen or aspirin, your doctor may recommend you continue taking them under their guidance, before considering another treatment.

These drugs can cause side effects, particularly if you take them for a long period of time. You are likely to be prescribed a short course of an NSAID at the lowest possible dose to treat your pain.

There are around 20 NSAIDs that are commonly prescribed, these include:

  • ibuprofen
  • ketoprofen
  • fenbufen
  • piroxicam
  • aspirin
  • naproxen
  • diclofenac
  • indomethacin
  • celecoxib
  • etoricoxib.

They can be taken as either:

  • tablets or capsules you swallow
  • a liquid you drink
  • a suppository, a medicine you place in your bottom
  • a cream, gel, spray, plaster, or mousse you apply to the skin – known as topical NSAIDs.

Your doctor should discuss with you the type of NSAID that’s best for you, and they should arrange regular check-ups to review your progress.

NSAIDs may not be suitable for everyone. The type of NSAID you are prescribed may depend upon other health issues, such as if you:

  • are over 65
  • might be pregnant or you’re breastfeeding
  • have asthma or allergies
  • have had a reaction to an NSAID
  • have had ulcers or bleeding in your stomach
  • have had problems with your heart, liver, kidneys, blood pressure, or circulation
  • are taking other medicines
  • have had a stroke
  • have problems with your stomach, intestines, or bowels such as ulcerative colitis or Crohn’s disease
  • problems with your blood pressure, circulation, or bleeding
  • have a condition affecting your connective tissue, such as lupus
  • experience persistent headaches.

Depending on what’s causing your pain, your doctor may first recommend trying a topical NSAID, such as ibuprofen, ketoprofen, felbinac and piroxicam, as they may cause fewer side effects than tablets.

They are often recommended for treating isolated areas of pain and inflammation caused by osteoarthritis, particularly in the hands and knees.

Topical NSAIDs may not be helpful for people with inflammatory conditions, such as rheumatoid arthritis, because their pain is more widespread.

However, NSAIDs are considered the most effective way of relieving pain and inflammation caused by rheumatoid arthritis.

NSAIDs can cause stomach problems so your doctor is likely to prescribe a drug called a proton-pump inhibitor (PPI), such as omeprazole or lansoprazole, to reduce the amount of acid in your stomach.

Some NSAIDs, such as celecoxib, etoricoxib, are designed to be gentler on your stomach.

Depending on your condition, you may be prescribed other drugs, such as disease-modifying anti-rheumatic drugs (DMARDs) or steroids. These drugs can help reduce your pain by treating the condition that’s causing it.

You can use NSAIDs if you are taking paracetamol. However, you should be careful taking NSAIDs with compound painkillers because some compound painkillers contain NSAIDs.

If you have concerns about taking NSAIDs seek advice from a healthcare professional.

Risks and side effects

If you’re taking anti-coagulant drugs to thin your blood, such as low-dose aspirin or warfarin, you’re best to avoid taking other NSAIDs or compound painkillers.

Even at low doses NSAIDs can cause side effects, such as:

  • headaches
  • dizziness
  • stomach pains, sickness, diarrhoea, and indigestion
  • bleeding
  • swollen ankles
  • problems when you pee
  • chest pains and difficulty breathing
  • a rash or sensitivity to sunlight.

If you experience any side effects, stop taking the pain relief and speak to your doctor.

Long-term use of NSAIDs, can cause problems with the liver, kidney, heart, and blood circulation.

NSAIDs can cause stomach problems and are best taken with food or a drink of milk to help reduce these side effects.

If you’re aged over 65, some NSAIDs can increase your risk of developing stomach ulcers. If you’re at risk of developing stomach problems or you get stomach pains after you’ve taken your NSAIDs, speak to your doctor.

NSAIDs can cause side effects and their long-term use should be monitored by a healthcare professional.

(Video) Pharmacology Analgesics - Opioids, NSAIDS, Tylenol - Nursing RN PN (MADE EASY)

Compound painkillers

Compound painkillers combine two types of pain relief medication.

Some compound painkillers are available over the counter from a pharmacist, others can only be prescribed by a healthcare professional.

For example:

  • co-codamol containing low-dose codeine and paracetamol, available over the counter
  • paracetamol and ibuprofen tablets, available over the counter
  • ibuprofen and codeine, available over the counter
  • co-dydramol containing paracetamol and dihydrocodeine, available on prescription
  • co-codaprin containing codeine and aspirin, available on prescription.

Depending on what is causing your pain, your doctor is likely to recommend you try paracetamol and NSAIDs, before prescribing compound painkillers.

Compound painkillers can be taken as tablets, capsules or dissolved in water.

Healthcare professionals are unlikely to prescribe compound painkillers containing the opioids codeine and dihydrocodeine for longer than a few days, because there’s little evidence that they help long-term pain.

Talk to your doctor if you’re taking compound painkillers but you’re still in pain.

To avoid accidentally taking too much of any drugs, make sure you know what your compound painkiller contains and avoid these ingredients while you’re taking it.

Because each of the ingredients can cause different side effects, compound painkillers may increase your risk of an unpleasant reaction.

Risks and side effects

Compound painkillers can reduce your pain, but they may cause more side effects.

Compound painkillers containing aspirin, paracetamol, or ibuprofen, carry the same risk of side effects as taking these drugs separately.

Common side effects of compound painkillers include:

  • feeling sick
  • drowsiness
  • feeling dizzy
  • heartburn or indigestion
  • constipation.

People who take painkillers containing opioids can become dependent on them if they take them for a long period of time.

Ask your doctor’s advice before using compound painkillers if you’re pregnant or breastfeeding.

Antidepressants

Low dose antidepressants can be prescribed to treat long term, persistent pain.

These drugs were originally developed to treat anxiety and depression. However, when taken at a lower dose they have been found to effectively treat pain. Doctors are now being encouraged to prescribe low dose antidepressants before other pain relief treatments.

If you are prescribed antidepressants, they can improve the way your body responds to pain, your mood, emotional state, and sleep quality.

Antidepressants commonly recommended for pain include:

  • amitriptyline
  • citalopram
  • duloxetine
  • fluoxetine
  • paroxetine
  • sertraline.

These drugs may not be suitable for everyone. Because they weren’t originally designed to treat pain, your doctor may first want to discuss the benefits and risks of prescribing them, before deciding whether an antidepressant would help your condition.

Antidepressants can affect other conditions, including:

  • diabetes
  • epilepsy
  • heart problems
  • glaucoma
  • overactive thyroid gland
  • severe liver disease.

Risks and side effects

Many people take antidepressants without experiencing any problems, but they can cause some side effects. Many of the more common ones go once your body gets used to them.

Side effects include:

  • constipation
  • dizziness
  • dry mouth
  • feeling sleepy
  • blurred eyesight
  • difficulty peeing
  • headache.

If these side effects don’t improve speak to your doctor or pharmacist.

Occasionally people can experience weakness down one side of their body, or trouble speaking, thinking, or balancing. If you experience these side effects seek urgent medical advice.

Some people also experience changes in their appetite and weight when they start taking antidepressants, if this concerns you speak to your doctor.

Some antidepressants can make you drowsy. You’re advised to avoid cycling, driving, or using machinery for the first few days of taking them, until you know how they affect you.

Nefopam

Nefopam is a non-opioid painkiller that can be prescribed to treat pain, if NSAIDs and paracetamol have not helped.

It causes fewer breathing problems than opioid drugs. It can sometimes be prescribed as an extra way of managing your pain with paracetamol, or NSAIDs such as ibuprofen or naproxen.

However, it has not been shown to be hugely beneficial to people with long term pain and can cause several side effects.

Risks and side effects

Nefopam can cause side effects including:

  • nausea
  • nervousness
  • confusion or seeing things that aren’t there
  • numbness and tingling in your hands or feet
  • problems when you pee
  • dry mouth
  • light-headedness.

You may not be able to take nefopam if you:

  • are epileptic or have ever had seizures
  • have liver or kidney problems
  • have problems peeing
  • have angle closure glaucoma.

If you are aged over 65 you may be more likely to feel confused or to see things that aren’t there. Nefopam is not usually recommended during pregnancy.

(Video) New warning for commonly used NSAID painkillers

Opioid painkillers and painkilling patches

Opioid painkillers can be prescribed to offer relief from moderate to severe pain when other forms of pain relief haven’t worked.

Some opioids are stronger than others. If your doctor feels your pain can only be helped by opioids they will prescribe the lowest dose, for the shortest time. Opioids are available as tablets, liquids, or patches.

However, because of the risk of side effects such as addiction and overdose, healthcare professionals are advised to avoid prescribing opioid painkillers for long-term pain, where possible. If you are prescribed opioid painkillers your treatment should be strictly monitored.

If you think your pain medicines aren't helping with your symptoms, or are causing unpleasant side effects, it might be a good idea to reduce or stop them. Discuss with your doctor how to minimise the risk of any withdrawal symptoms. This could include gradually reducing the dose, and having regular reviews with your healthcare team.

Opioid painkillers include:

  • codeine
  • dihydrocodeine
  • tramadol
  • buprenorphine
  • fentanyl
  • morphine
  • diamorphine
  • oxycodone
  • tapentadol.

The low-dose codeine used in compound painkillers is the only opioid painkiller available without a prescription.

Opioid patches

Your doctor may consider prescribing you a course of treatment with opioid patches if you’ve tried a low-dose opioid, such as morphine, and you’re still in pain.

These patches usually contain either buprenorphine or fentanyl, which is slowly released into the body over a period of several days. For guidance on how often you should change your patch, see the patient information leaflet included in the pack.

You should only wear one patch at a time, unless told otherwise by your doctor.

You should keep the area the patch is stuck to away from any source of heat, such as a hot water bottle, electric blanket or heat pads, or sunlight. This is because heat can cause too much of the drug to be released into the blood stream too quickly.

You should inform any healthcare professional treating you that you are using opioid patches, as they can interact with other drugs.

Risks and side effects

Opioid painkillers commonly cause more side effects than other pain treatments and they need to be strictly monitored by your doctor.

Risks and side effects of opioid painkillers include:

  • feeling or being sick
  • problems going to the toilet
  • itching
  • drowsiness and dizziness
  • not being able to concentrate
  • low sex drive, reduced fertility, and erectile dysfunction
  • more difficulty fighting off infections
  • increased pain
  • breathing problems.

Some side effects will lessen over the course of treatment. If you are concerned speak to your doctor.

If you have breathing problems, such as sleep apnoea, asthma, or chronic obstructive pulmonary disease (COPD), speak to your doctor before taking opioid painkillers.

Taking opioids with sedative drugs, such as diazepam, temazepam, or alcohol, can make you more likely to feel drowsy, dizzy, and unable to concentrate.

Opioid drugs can cause seizures. If you are taking antipsychotic or antidepressant drugs you could be more likely to experience seizures if you are prescribed the opioid drug tapentadol.

Opioid painkillers can become addictive and should be used with caution. Speak to your doctor if you feel they aren’t working at the prescribed dose, or you are still in pain after finishing a course of opioid painkillers.

Your doctor may recommend you stop taking opioids. Depending on how long you have been taking them you may experience some reactions, including:

  • tremors or muscle spasms
  • anxiety, sweating, or restlessness
  • sickness, diarrhoea, or stomach cramps.

If you have been taking opioid painkillers for a long period of time you should only stop taking them under the guidance of a healthcare professional, as suddenly stopping your treatment can be dangerous.

Effect of painkillers and NSAIDs on other treatments

Many people with arthritis and related conditions will need to take painkillers or NSAIDs, along with drugs that treat the underlying cause of their condition. The combination you take and the length of time you take them for will depend on your condition.

For inflammatory types of arthritis, such as rheumatoid arthritis, your doctors should recommend starting treatment with a disease-modifying anti-rheumatic drug (DMARD), such as methotrexate.

DMARDs won’t stop your pain straight away, but once they start to work, you should be able to reduce or stop your pain relief drugs.

If you have gout, you may be prescribed the anti-inflammatory drug colchicine or an NSAID to deal with the pain and swelling from an attack. Aspirin may make your gout worse. You may need to take another drug, such as allopurinol or febuxostat, in the longer term to reduce the risk of having more gout attacks.

If you have osteoarthritis of the hand or knee, you can use capsaicin cream to treat the affected joints several times a day, as well as taking painkillers.

If you’re taking medications for other conditions, you should speak to your doctor or a pharmacist about possible interactions.

Complementary treatments

Complementary treatments, such as herbal remedies, vitamins, and supplements, are not tested the same way as painkillers and NSAIDs, so it’s difficult to say whether they are safe to take together.

You should always tell the healthcare professional treating you about any other medications you are taking, including complementary treatments, herbal remedies, vitamins, or supplements, before you start your prescribed medication.

(Video) Pain | Pathway and Analgesics (NSAIDs, Opioids, Antidepressants, and Anticonvulsants)

Alcohol

Most people who take painkillers or NSAIDs can drink alcohol in moderation.

Alcohol can increase the risk of side effects of some painkillers and NSAIDs. It’s a good idea to read the leaflet that comes with your drug to see what it says about drinking alcohol.

If you’ve just started taking opioid painkillers, or your dose is increased, you’re advised to avoid drinking alcohol until you’ve settled on your medication. Alcohol and opioid painkillers can affect your concentration and can make you sleepy.

You’re advised to avoid alcohol if you’re driving or using machinery.

It’s best to stick within government guidelines of drinking no more than 14 units of alcohol per week, and to spread the units through the week. Having two or three days each week when you don’t drink alcohol is good for you.

Talk to your doctor or a pharmacist if you have any concerns.

Fertility, pregnancy, and breastfeeding

If you’re planning to start a family or you become pregnant, you should discuss your medication with your doctor as soon as possible.

Paracetamol is usually the recommended pain relief option if you’re pregnant or breastfeeding, but it’s a good idea to talk to your healthcare professional about any medications.

NSAIDs are not usually recommended in pregnancy, especially after 30 weeks, unless you’re advised to take them by your doctor.

In rare cases low-dose aspirin may be continued during pregnancy but only under specialist care for severe conditions, including:

  • high blood pressure
  • certain other long-term conditions - such as lupus.

NSAIDs are considered safe to take if you are breastfeeding.

Low dose antidepressants are considered safe during pregnancy.

Paracetamol and opioid painkillers may be used during pregnancy, although it is recommended that you do not use them regularly or for long periods.

Taking opioids in pregnancy can increase the risk of your baby having breathing problems, experiencing painful effects from withdrawal, and may affect their brain function in future. They should only be taken under the guidance of a doctor.

Some low doses of opioids, such as dihydrocodeine, are considered safe if you’re breastfeeding, but you should avoid anything containing codeine.

If you’re a pregnant woman who has been taking opioids every day for a while, you shouldn’t suddenly stop using them without speaking to your doctor.

Stopping opioids without help from your doctor or midwife can be dangerous for yourself and your child, particularly in your first trimester when it can cause miscarriage, and the last trimester when it can increase the risk of birth complications and stillbirth.

Related information

  • Pregnancy and arthritis Find out more about how arthritis symptoms may change with pregnancy and advice on taking medication.

FAQs

Can you take painkillers with NSAIDs? ›

Do not take naproxen with ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs). But it's OK to take naproxen with paracetamol or co-codamol that you buy over the counter. This should just be for short periods of time.

What drugs should not be taken with NSAID? ›

Drug interactions with NSAIDs

When combined with blood-thinning medicines (such as warfarin) NSAIDs increase the risk of bleeding. NSAIDs can cause kidney failure when they are combined with ACE inhibitors (medicines used to treat heart problems and high blood pressure) and diuretics (medicines to remove excess fluid).

What are the 3 most common NSAIDs? ›

Most Common NSAIDs
  • Bayer, Ecotrin, Bufferin (aspirin)
  • Motrin, Advil (ibuprofen)
  • Aleve, Naprosyn (naproxen )
  • Mobic (meloxicam)
  • Celebrex (celecoxib)
  • Indocin (indomethacin)
9 Jul 2022

What is the strongest painkiller? ›

Vivien Williams: Fentanyl is a powerful painkiller. Mike Hooten, M.D. (Anethesiology, Mayo Clinic): It is many, many times more potent than morphine, oxycodone, oxycontin, Vicadin, dilaudid, hydromorphine, all these types of drugs. Vivien Williams: Mayo Clinic pain management specialist Dr.

Can I take NSAIDs with paracetamol? ›

You can take paracetamol with NSAIDs, such as ibuprofen or aspirin, or with another painkiller called codeine. However, be careful if you're taking medicines for migraines, coughs, colds and flu, or compound painkillers, because these drugs often already contain paracetamol.

Which is the safest NSAID? ›

Experts say that taking NSAIDs for a short time at the lowest effective dose is generally safe.
...
This class of medications includes:
  • Aspirin (full dose)
  • Celecoxib (used in Celebrex)
  • Diclofenac (used in Votaren)
  • Ibuprofen (used in Advil or Motrin)
  • Naproxen (used in Aleve)
19 Nov 2021

Is Tramadol an NSAID? ›

Tramadol is not approved for as-needed pain relief. It is not a nonsteroidal anti-inflammatory drug (NSAID). It works differently than NSAIDs and has different side effects.

Which tablet is best for painkiller? ›

Ibuprofen (Advil, Motrin), aspirin/citric acid/sodium bicarbonate (Alka-Seltzer), naproxen (Aleve), acetaminophen (Tylenol), and aspirin are some of the top-rated over-the-counter (OTC) pain relief medications.

When should NSAIDs be avoided? ›

NSAIDs are generally not recommended for people with kidney disease, heart failure, or cirrhosis, or for people who take diuretics. Some patients who are allergic to aspirin may be able to take selective NSAIDs safely, although this should be discussed in advance with a health care provider.

What organs are damaged mostly by taking NSAIDs? ›

It's estimated that between 1 and 10 out of every 100,000 people experience liver damage with NSAIDs. For most people, NSAIDs available today pose little risk for liver damage. Liver problems with NSAIDs have a higher likelihood of happening to people who already have a higher risk for experiencing liver damage.

What medications Cannot be taken with ibuprofen? ›

It's safe to take ibuprofen with paracetamol or codeine. But do not take ibuprofen with similar painkillers like aspirin or naproxen without talking to a pharmacist or doctor. Ibuprofen, aspirin and naproxen belong to the same group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs).

What is best for inflammation? ›

Omega-3 fatty acids play a role in regulating your body's inflammatory process and could help regulate pain related to inflammation. Find these healthy fats in fish like salmon, tuna and mackerel, as well as smaller amounts in walnuts, pecans, ground flaxseed and soy. Eat less red meat.

What is a stronger anti-inflammatory than ibuprofen? ›

Meloxicam is considered a stronger medicine than ibuprofen.

Is tramadol stronger than codeine? ›

Official answer. Both tramadol and codeine are prescription opioid painkillers, and they seem to be equally effective in terms of pain relief. There is no evidence that tramadol is any stronger than codeine at relieving pain.

Are Nsaids addictive? ›

Nsaids carry no risk of addiction, and depending on the amount of pain, they may eliminate the need for stronger medications. Nsaids, however, may interfere with blood clotting and may cause nausea, vomiting, or kidney problems.

Can I take 2 paracetamol and 2 ibuprofen together? ›

It's safe to take paracetamol with other types of painkiller that don't contain paracetamol, such as ibuprofen, aspirin and codeine. Do not take paracetamol alongside other medicines that contain paracetamol. If you take 2 different medicines that contain paracetamol, there's a risk of overdose.

Which pain reliever is not an NSAID? ›

Acetaminophen (Tylenol) is known as a non-aspirin pain reliever. It is NOT an NSAID, which is described below. Acetaminophen relieves fever and headaches, and other common aches and pains. It does not relieve inflammation.

How do you space out paracetamol and ibuprofen? ›

Paracetamol and ibuprofen can be given together, but you can stagger them so that every few hours, if needed, the child can have some medication. For example, you can give paracetamol at 8am, ibuprofen at 11am and paracetamol again at 2pm (i.e. six hours after the first dose of paracetamol).

What are the dangers of taking NSAIDs? ›

NSAIDs can cause severe or life-threatening gastrointestinal (GI) bleeding and ulcers in some people. NSAIDs have also been linked to a higher risk of strokes, heart attacks, and heart-related deaths, especially when used for a long period of time.

Which NSAID is best for long term use? ›

Among traditional nonselective NSAIDs, diclofenac represents the greatest cardiovascular risk. In contrast, naproxen seems to have the safest cardiovascular profile and is the best treatment option in patients with high cardiovascular risk.

Which NSAID is safest for kidneys? ›

Ibuprofen was the safest NSAID, conferring a significant 12% increased risk of incident eGFR less than 60, 32% increased risk of an eGFR decline of 30% or greater, and 34% increased risk of the composite outcome. Etoricoxib had the largest negative effect on kidney function.

Why does tramadol not help my pain? ›

The drug's opioid effect is about one-tenth as strong as that of morphine. Because of this, the drug is not usually effective by itself for the treatment of severe pain or long-term chronic pain. In these instances, Tramadol may be used in combination with other pain relievers.

Who should not take tramadol? ›

Do not give this medicine to: Children younger than 12 years of age. Children younger than 18 years of age who have had surgery removal of tonsils or adenoids. Children 12 to 18 years of age who have a high risk for breathing problems (eg, obstructive sleep apnea, obesity, lung disease).

Is Gabapentin a NSAIDs? ›

Gabapentin is used as an anticonvulsant, sedative, anxiolytic, and to treat chronic pain syndromes, including neuropathic pain. It is used to treat neuropathic pain that does not respond to nonsteroidal anti-inflammatory drugs (NSAIDs) or opiates.

What drugs do doctor's prescribe for severe pain? ›

Doctors prescribe opioids – like hydrocodone, oxycodone, and morphine – to treat moderate to severe pain. Opioids are often prescribed following a surgery or injury or for certain health conditions.

How do painkillers know where the pain is? ›

It doesn't go directly to your shin or head, even though that's the spot that hurts so much. Pain relievers work with your cells, your body's nerve endings, your nervous system, and your brain to keep you from feeling the pain.

Can you take too many painkillers? ›

Pain relief medication is generally safe if taken as directed. But taking too much of these medicines can lead to liver damage, stomach bleeding, and kidney disease. Learn how you can protect yourself and your family from unintentional overdosing.

Why do NSAIDs increase risk of stroke? ›

Aspirin prevents platelets from clumping together, which prevents the formation of dangerous clots that can block a vessel and cause a heart attack or stroke. The non-aspirin NSAIDs work on that enzyme, too, but also affect another enzyme that promotes clotting. That can lead to heart attacks and strokes.

Why do NSAIDs increase risk of blood clots? ›

NSAIDs work by blocking a specific group of enzymes called cyclo-oxygenase enzymes (COX enzymes). These enzymes are involved in the production of prostaglandins which control many different processes such as inflammation, blood flow, and the formation of blood clots.

Do NSAIDs damage kidneys? ›

NSAIDs can induce several different forms of kidney injury including hemodynamically mediated acute kidney injury (AKI); electrolyte and acid-base disorders; acute interstitial nephritis (AIN), which may be accompanied by the nephrotic syndrome; and papillary necrosis (table 1).

How do I protect my stomach with NSAIDs? ›

Take NSAIDs at the end of a full meal or with an antacid

Drugs that reduce stomach irritation include misoprostol (Cytotec), or a proton pump inhibitor such as omeprazole (Prilosec), esomeprazole (Nexium), pantoprazole (Protonix), lansoprazole (Prevacid), or rabeprazole (Aciphex).

Can I take an NSAID every day? ›

Don't use an over-the-counter NSAID continuously for more than three days for fever, and 10 days for pain, unless your doctor says it's okay. Over-the-counter NSAIDs work well in relieving pain, but they're meant for short-term use.

Is NSAID damage reversible? ›

Generally, the renal failure with NSAIDs is acute and reversible, though analgesic nephropathy with papillary necrosis and chronic renal failure are reported.

How much paracetamol and ibuprofen can I take together? ›

Maxigesic (AFT Pharmaceuticals) contains a combination of paracetamol 500 mg and ibuprofen 150 mg in a single tablet. The recommended dose in individuals 12 years and over is 1–2 tablets every 6 hours as required, to a maximum of eight tablets in 24 hours.

Can ibuprofen raise blood pressure? ›

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

This may cause your blood pressure to rise even higher, putting greater stress on your heart and kidneys. NSAIDs can also raise your risk for heart attack or stroke, especially in higher doses. Common NSAIDs that can raise blood pressure include: Ibuprofen (Advil, Motrin)

What painkiller can I take with high blood pressure? ›

Acetaminophen (Tylenol) is often the pain reliever of choice for people with high blood pressure (hypertension) because most other options are types of nonsteroidal anti-inflammatory drugs like ibuprofen (Motrin, Advil) or naproxen (Naprosyn, Aleve), which can raise blood pressure.

Can you take 2 paracetamol and 2 ibuprofen together? ›

It's safe to take paracetamol with other types of painkiller that don't contain paracetamol, such as ibuprofen, aspirin and codeine. Do not take paracetamol alongside other medicines that contain paracetamol.

How many ibuprofen and paracetamol can I take together? ›

Maxigesic (AFT Pharmaceuticals) contains a combination of paracetamol 500 mg and ibuprofen 150 mg in a single tablet. The recommended dose in individuals 12 years and over is 1–2 tablets every 6 hours as required, to a maximum of eight tablets in 24 hours.

What happens if you take 2 NSAIDs? ›

Most commonly, abdominal discomfort, nausea and/or vomiting can occur when someone takes too much of an NSAID. If you think you may have taken too much, or if you develop symptoms, talk with your doctor or call your regional poison center at 1-‐800-‐222-‐1222 for advice.

What are the dangers of taking NSAIDs? ›

NSAIDs can cause severe or life-threatening gastrointestinal (GI) bleeding and ulcers in some people. NSAIDs have also been linked to a higher risk of strokes, heart attacks, and heart-related deaths, especially when used for a long period of time.

How do you space out paracetamol and ibuprofen? ›

Paracetamol and ibuprofen can be given together, but you can stagger them so that every few hours, if needed, the child can have some medication. For example, you can give paracetamol at 8am, ibuprofen at 11am and paracetamol again at 2pm (i.e. six hours after the first dose of paracetamol).

How do you mix paracetamol and ibuprofen? ›

Can I take ibuprofen and paracetamol together? - YouTube

Can you overdose on 1200mg ibuprofen? ›

Like any drug, if ibuprofen is taken in higher than recommended doses, it can harm your health. Overuse of ibuprofen can seriously damage your digestive system, interfere with your hormones, and increase your risk of heart attacks and stroke. In some cases, ibuprofen overdose can be deadly.

What happens if you take 4 500mg paracetamol at once? ›

If the glutathione runs out, then the toxic substances build up and damage liver cells. An adult body can produce enough glutathione to safely clear 4 grams of paracetamol every 24 hours which is why it is the recommended dose. Taking more than this amount risks permanent and even fatal liver damage.

Which is better ibuprofen or paracetamol? ›

“The main takeout is that paracetamol is safer, because of those groups that are slightly more at risk, but if there's an inflammatory component, then you're better off taking ibuprofen,” Hamish says. Taking either medicine consistently over a long period isn't wise, particularly as you get older.

What happens if you take too much paracetamol and ibuprofen? ›

If you develop any of the following symptoms, you must seek medical advice immediately. Abdominal (stomach) pain, nausea, vomiting (sickness). Yellow discoloration of the skin or whites of the eyes (jaundice). Severe headache, confusion or drowsiness.

What organs are damaged mostly by taking NSAIDs? ›

It's estimated that between 1 and 10 out of every 100,000 people experience liver damage with NSAIDs. For most people, NSAIDs available today pose little risk for liver damage. Liver problems with NSAIDs have a higher likelihood of happening to people who already have a higher risk for experiencing liver damage.

When should NSAIDs not be used? ›

Who Should Not Take NSAIDs?
  • You have had serious side effects from taking a pain reliever or fever reducer.
  • You have a higher risk of stomach bleeding.
  • You have stomach problems, including heartburn.
  • You have high blood pressure, heart disease, liver cirrhosis, or kidney disease.
  • You have asthma.
4 Dec 2020

How much NSAIDs can I take in a day? ›

adults – can usually take 1 or 2 tablets (200mg) every 4 to 6 hours, but shouldn't take more than 1,200mg (6 x 200mg) tablets in the space of 24 hours. children under 16 – may need to take a lower dose, depending on their age; check the packet or leaflet, or ask a pharmacist or doctor for advice.

Which is the safest NSAID? ›

Experts say that taking NSAIDs for a short time at the lowest effective dose is generally safe.
...
This class of medications includes:
  • Aspirin (full dose)
  • Celecoxib (used in Celebrex)
  • Diclofenac (used in Votaren)
  • Ibuprofen (used in Advil or Motrin)
  • Naproxen (used in Aleve)
19 Nov 2021

Why do NSAIDs cause heart attacks? ›

Aspirin prevents platelets from clumping together, which prevents the formation of dangerous clots that can block a vessel and cause a heart attack or stroke. The non-aspirin NSAIDs work on that enzyme, too, but also affect another enzyme that promotes clotting. That can lead to heart attacks and strokes.

What is the most common side effect of NSAIDs? ›

The most common side effects of NSAIDs are gastrointestinal problems, including stomach irritation and reflux. More rarely, NSAIDs can contribute to heart problems and increase the risk of cardiovascular conditions.

Videos

1. Pharmacology - Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
(Armando Hasudungan)
2. What over-the-counter painkiller is the best at killing pain?
(Osmosis)
3. Mayo Clinic Minute: What are NSAIDs?
(Mayo Clinic)
4. Pharmacology - NSAIDs & PROSTAGLANDIN ANALOGS (MADE EASY)
(Speed Pharmacology)
5. How Do Pain Relievers Work? - George Zaidan
(TED-Ed)
6. UF study strengthens concerns about long-term use of certain painkillers
(UF Health)

Top Articles

Latest Posts

Article information

Author: Jerrold Considine

Last Updated: 01/11/2023

Views: 5501

Rating: 4.8 / 5 (58 voted)

Reviews: 89% of readers found this page helpful

Author information

Name: Jerrold Considine

Birthday: 1993-11-03

Address: Suite 447 3463 Marybelle Circles, New Marlin, AL 20765

Phone: +5816749283868

Job: Sales Executive

Hobby: Air sports, Sand art, Electronics, LARPing, Baseball, Book restoration, Puzzles

Introduction: My name is Jerrold Considine, I am a combative, cheerful, encouraging, happy, enthusiastic, funny, kind person who loves writing and wants to share my knowledge and understanding with you.