Open a PDF version to print this topic

HealthInfo Waitaha Canterbury

Pain relief for adults

Whakaoranga mamae ki ngā pakeke

There are three main types of pain-relief medicines for adults to use for short-term pain: paracetamol, anti-inflammatories (NSAIDs) and opioid pain relievers.

Paracetamol

Paracetamol is easy to buy from a pharmacy or supermarket without a prescription. It's important to take it at the recommended dose so the medicine works well and doesn't cause unwanted effects.

For most adults, the dose is two 500 mg tablets every four to six hours, but no more than eight tablets over 24 hours. Taking more than the recommended dose can be dangerous and can cause permanent damage to your liver.

Many combination products, such as cold and flu medicines, contain paracetamol. You shouldn't take these at the same time as plain paracetamol or you may take an overdose.

If you need stronger pain relief, you should consult your general practice team.

Anti-inflammatories (NSAIDs)

Ibuprofen, naproxen and diclofenac are all non-steroidal anti-inflammatory drugs (usually called NSAIDs). Although they're often very effective for pain, they do have significant risks and aren't suitable for everyone to take. They are useful for treating pain and conditions where there is some inflammation, such as arthritis or muscle sprains.

If you think you need to take an NSAID regularly for more than a week or two, you should tell your general practice team. They can assess you to see if you're safe to continue using it and monitor you for any problems or side effects. You shouldn't take NSAIDs if you've had a stomach ulcer, asthma, problems with your kidneys or heart disease.

Important

If you take an ACE inhibitor or angiotensin II receptor blocker (ARB) (for example, cilazapril, enalapril, quinapril, losartan or candesartan) and a diuretic (for example, furosemide or bendroflumethiazide), taking a non-steroidal anti-inflammatory drug (NSAID) (for example ibuprofen or aspirin) in high doses could harm your kidneys.

The term for this is "triple whammy". Read NSAIDs and blood pressure medicines for more details.

Check with your general practice team or pharmacist if you aren't sure whether you're taking an ACE inhibitor or angiotensin II receptor blocker (ARB) and a diuretic.

Opioid pain relievers

Codeine, morphine, oxycodone and tramadol are strong pain relievers that are only available on prescription, but which can help with severe pain.

All opioids have many possible side effects, such as constipation, drowsiness and nausea. If you're concerned about any side effects, talk to your pharmacist or general practice team.

Opioids are often effective for short-term, severe pain and are useful in palliative care. But they may have several serious side effects if you use them long term. Generally, they become less effective if used for longer than seven days, as your body becomes used to them and needs higher doses for the same effect. This is called tolerance. So, it's best to use these medicines for short-term pain, such as after a major injury rather than for treating long-term (chronic) pain.

Becoming addicted to opioid pain relievers (also called dependence) can be a problem for some people. People who have had addiction problems in the past are most at risk of becoming addicted. If you're concerned about this, talk to your pharmacist or general practice team. If you're prescribed an opioid, your general practice team will need to see you regularly so they can monitor how well the medicine is working and keep track of any problems.

Products containing low-dose codeine can no longer be purchased from pharmacies.

Other pain relievers

Other medicines, such as some antidepressants and anti-epileptic medications, can be used to treat nerve (neuropathic) and long-term (chronic) pain.

Pain relief and other medicines

Some pain relief can interact with other medicines that you might take. This can cause reactions or reduce how well one or other of the medicines work. Always check with your general practice team or pharmacist before taking pain relief with other medicines.

  HealthInfo recommends the following pages

Written by HealthInfo clinical advisers. Last reviewed March 2023.

See also:

Drug overdose

Medication for chronic pain

Medications in pregnancy

Pain relief & professional treatment for back pain

Pain relief for long-term joint pain & arthritis

Sources

Page reference: 370908

Review key: HIPRF-370907