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Pain relief for adults on discharge from hospital

This page gives you advice about managing your pain relief after being discharged from hospital following an injury or operation.

Taking pain relief

Follow the instructions on medication packets and listen to advice from medical staff.

If the instructions are to take the medication regularly, take the recommended dose at the specified time interval, for example, every six hours.

If the instructions are to take the medication if required, take the recommended dose if you're sore.

If you're still sore around 45 minutes after taking a pain reliever, try a different type of pain reliever. Don't take another dose of the first pain reliever until the instructions say you can.

If the instructions give a range of doses, for example, 50 to 100 mg, try taking the smaller dose first. If you're still sore around 45 minutes later, try a different type of pain reliever. Next time you're sore, try the larger dose of the first pain reliever.

Don't take another dose of a pain reliever until the instructions say you can. Never take more than the prescribed dose. You could have serious side effects if you take more than is prescribed.

If you're concerned about side effects when you're at home, stop taking the medication and talk to your GP.

After surgery or an injury, it's likely that your pain will improve each day.

Paracetamol

You can take paracetamol (Panadol) on its own, or in combination with other pain relief for more severe pain. It's most effective if you take it regularly. The usual adult dose is two 500 mg tablets every six to eight hours, but no more than four times in 24 hours. As long as you take it correctly, it's a very safe medicine and has very few or no side effects for most people. But taking more than the recommended dose can cause life threatening liver damage.

Anti-inflammatories

Anti-inflammatories like Ibuprofen, naproxen, and diclofenac are often very effective and can also help reduce swelling. They can irritate or damage the lining of your stomach so you should take them with food, which can ease this problem. If you notice any new stomach pain or indigestion you should stop taking them. You usually won't be prescribed these if you've had a stomach ulcer, problems with your kidneys, or heart disease.

Opioids

Opioids like codeine, morphine, oxycodone, and tramadol can have serious side effects so you should use them carefully. If you're taking a combination of medications, you should reduce and stop taking the opioids first.

Opioids are strong pain relievers but tramadol and codeine are weaker than morphine and oxycodone.

Constipation is a common side effect with opioids. To help prevent this, eat plenty of fibre and drink plenty of water. You may be prescribed laxatives to take along with opioids.

Other possible side effects include nausea and sleepiness or spaced-out feelings (see the safety section below). If you have side effects, taking a smaller dose may make them less likely. If you keep having side effects, stop taking the medication and contact your GP.

Other medications used for pain relief

Some anti-depressants and anti-epileptic medications, can be used to treat nerve pain (neuropathic) and persistent pain. Examples include nortriptyline, amitriptyline, and gabapentin.

How long should I take pain relief for?

The aim of pain relieving medications is to reduce your pain to a level where you can get on with a normal life. They usually don't get rid of the pain completely. After an operation, we want you to be able to:

As your body heals, you'll be able to reduce the amount of pain relief you're taking. You should stop the strongest pain relievers first, followed by the weaker ones. For example, you should stop oxycodone and morphine first, then tramadol and codeine, then anti-inflammatories, and lastly paracetamol.

If you have a condition that means you need to keep taking pain relief, or you're taking long-acting, slow-release opioids, you should talk to your GP for help with reducing pain relieving medications.

What if I still have pain?

If you can't reduce the amount of pain relief you're taking, or feel your pain is getting worse, you should see your GP as soon as possible.

Will I become addicted?

Addiction is uncommon with short-term use of opioids. But it's important that you only take them for pain, not because they make you feel good. If you have to take opioids for a week or longer, your body will get used to the medication. In this case, you may need to reduce the amount you're taking slowly to avoid having withdrawal symptoms. This is called tolerance and isn't the same as addiction.

Safety

Alcohol and recreational drugs

It's best to avoid taking these while taking opioids as you can become very sleepy, unconscious and even stop breathing.

Driving or operating machinery

Don't drive or operate heavy machinery while taking opioids, since you may be drowsy and have slow reaction times.

Sharing with others

All drugs can be dangerous and you shouldn't give them to anyone else, including family members.

Storage

You should store all medications in a safe place, out of sight and easy reach of others, especially children. Opioids are dangerous. You should return all unused opioids to your pharmacist.

Over-the-counter drugs and supplements

Many medicines that are available without a prescription can react with opioids and can increase their side effects. For example, antihistamines such as promethazine (Phenergan) increase drowsiness.

Over-the-counter medicines often contain paracetamol, ibuprofen or codeine. Examples are Panadeine and some cough syrups. If you take these while taking prescribed pain relief, you might take an overdose.

Tell your pharmacist and doctor about all medicines or treatments you're taking, including herbal products, vitamins, and recreational drugs.

Written by the Opioid Collaboration Group and Acute Pain Management Service, Canterbury DHB. Adapted by HealthInfo clinical advisers. Page created April 2018.

Page reference: 486683

Review key: HIPRF-370907