0917 pain management leaflet_v3:0917 pain management leaflet_v3
What side effects do painkillers have
and what are the risks of taking
painkillers in the long-term?
Although, addiction to codeine and dihydrocodeine
is rare, if it does occur it is a serious problem. Never take painkillers containing codeine or
dihydrocodeine for longer than three days
All medicines can cause unwanted side effects.
without medical advice.
Used in the short-term these are not generally
You may find it helpful to read ‘Pain and substance
troublesome but if painkillers are used long-term,
misuse: improving the patient experience
then the extent and severity of side effects can
by the British Pain Society which can be downloaded
increase. If you have any unwanted side effects
or if you have any concerns, you should seek advice from your doctor, pharmacist or otherhealthcare professional.
How do I know if I am addicted?
Paracetamol is a safe drug, except in overdosewhen the liver can become damaged, sometimes
• Do you feel that you need to take the
codeine/dihydrocodeine products for longerperiods of time than instructed on the pack?
High doses or long-term use of NSAIDs may lead toindigestion, bleeding from the gut, kidney
• Do you find yourself buying more and more pills?
problems, high blood pressure, fluid retention, and
• Do you feel the need to take more than the
slight increased risk of heart attack and stroke. They
may also affect blood clotting and worsen asthma
• Do you feel very unwell when you stop taking the
in about 10% of asthma sufferers. Aspirin must not
medicine but you feel better if you start taking
be given to children under 16 years because of a
very rare illness called Reye’s syndrome which
If you answer “yes”
to any of these questions then
you need help in managing your symptoms and it is
Prolonged use of painkillers containing codeine or
important that you talk to your doctor. If you take
dihydrocodeine can lead to constipation, “chronic
the medicine according to the instructions on the
pack, it is unlikely that you will become addicted to
Chronic daily headache
If you are taking painkillers for 15 days or more a month you run the risk of getting daily or near-daily headaches that last, on average, for
We all know what pain is. Sometimes we hardly notice it. However, other times it is so
more than four hours. These headaches are
severe that we ask a doctor or pharmacist for help. Sometimes we take a painkiller
often linked to overuse of painkillers. Unless the
(analgesic) to lessen the pain until it goes away.
overused painkillers are completely discontinued,the chronic daily headache is likely to continue.
Short-term (acute) pain relief
Long-term pain relief
If you suffer from this then you need to see yourdoctor who can help you.
Most of us have had occasional headaches,
Long-term pain, sometimes called chronic or
muscle or joint pain, or in women, period pain.
persistent pain, is present everyday or comes and
Short-term pain does not last long and tells
goes. Some people with long-term illnesses need
to take painkillers everyday to manage this.
Short-term pain can be treated by painkillers
You may find it helpful to read ‘Understanding
that can be bought “over the counter” (OTC)
and Managing Pain
’ published by the British Pain
either from a pharmacy or other shop, such
This leaflet is available to
download from www.pagb.co.uk
You do not always need painkillers to
What do the other ingredients do?
i SAFE USE OF PAINKILLERS
Some painkillers contain caffeine as it may improve
• When taken at the right dose, OTC painkillers are safe and effective medicines.
• Applying heat to the skin can help some types
pain relief. Caffeine, also in coffee and tea, is a
• When you have short-term pain it may be best to take the painkiller as recommended on the pack to
of pain. Use compresses or products such as
stimulant. It increases blood pressure and speeds up
stop the pain from building up and becoming intolerable.
sprays, creams, ointments, gels and patches to
the heart. There is about 75 mg caffeine in a small
• If you need to take painkillers for longer than three days you should see your doctor or pharmacist
cup of coffee and about 50 mg in a small cup of
• Support from bandages or compression hosiery
tea, similar amounts to some OTC painkillers.
• If you feel the dose of a prescription medicine isn’t enough, don’t ‘top up’ with painkillers bought over
Increasing caffeine intake may increase the
the counter - Talk to your doctor or pharmacist.
Acupuncture or Transcutaneous Electrical Nerve
• Speak to your doctor or pharmacist if you need advice.
Doxylamine, a sedating antihistamine, has
medication for pain control. Ask a healthcare
muscle relaxing properties thought to be
professional about these treatments.
i MANAGE YOUR PAIN EFFECTIVELY AND SAFELY
Does your pain affect your life?
• Exercise gently as soon as you are able to.
WITH OTC MEDICINES
Long-term pain can often affect your quality of life.
Ask yourself what is causing the pain. If you do not
know, if the pain persists for more than three days,
or if you are unwell, always seek medical advice.
• Do you need to take this medicine continuously
What kinds of pain can be helped by
Always read the instructions and do not take two products containing the same active ingredient. Codeine
or dihydrocodeine containing painkillers should only be used for short-term treatment of acute, moderate
pain which is not
relieved by paracetamol, ibuprofen, naproxen, diclofenac, or aspirin alone. Some OTC
painkillers can only be used to treat specific conditions.
• Do you find it difficult to concentrate?
• Does the pain make it difficult for you
If you answer “yes”
to any of these questions
i ALWAYS READ THE INSTRUCTIONS AND
then you need help in managing your symptoms
INFORMATION IN THE LEAFLET AND PACK
How do different painkillers work?
and it is important that you talk to your doctor.
Aspirin, ibuprofen, diclofenac and naproxen
Although it may not always be possible to get rid
• It can be dangerous to take more than one painkiller with the same active ingredient. Make sure you
know the ingredients of the products that you are taking.
come from a group of drugs called nonsteroidal
of pain completely, there is a range of different
anti-inflammatory drugs (NSAIDs). NSAIDs work by
• If you have conditions like asthma, any stomach problems or if you are taking certain medicines, then
changing the body’s response to pain and swelling.
some painkillers may not be suitable for you and you should speak to your pharmacist or doctor about
They are particularly helpful for acute strains and
which painkiller would suit you best. Always read the instructions and information in the leaflet and pack.
• Some people may have side-effects when taking medicines. You can help to make sure that
! BEWARE! MEDICINES HAVE
medicines remain as safe as possible by reporting any unwanted side-effects via the internet at
Codeine and dihydrocodeine are similar to, but
MORE THAN ONE NAME
or through your pharmacy.
weaker than morphine, and work by blocking painmessages in the brain and spinal cord.
A brand name is the name chosen by a manufacturer (e.g. Panadol®, Nurofen®, Voltarol®,
Paracetamol works in a different way to NSAIDs
Feminax®). Each drug may have several different
and codeine. It is particularly helpful in reducing
brand names. The “active ingredient” describes the
i UNDERSTAND WHAT YOU ARE TAKING
drug (e.g. paracetamol, ibuprofen, diclofenac and
• Keeping a pain and medicine diary can ensure that you are using your painkillers most effectively.
naproxen). Always read the instructions and
Because each type of painkiller works in a
do not take two products with the same active
different way to relieve pain, there are some
• Never take painkillers more frequently than it says on the instructions on pack or in the leaflet.
ingredient. Make sure you know the ingredients
products available that contain more than
• Always read the names of the ingredients and information on the leaflet and pack.
of the products that you are taking. These will be
one type of painkiller. For example aspirin,
clearly marked on the pack.
Never take another product sooner than you should.
paracetamol or ibuprofen can be combined
Your pharmacist and their assistants can advise you on an appropriate choice of product.
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Evaluation and Validation of the KMT Mouse Model for Testing Anti-Viral Hepatitis Therapies N. Kneteman*#, T.J. Gao#, B. His*, D. Schiller*, D. Douglas*, B. Addison** and D.L.J. Tyrrell**# Departments of Surgery*, Medical Microbiology and Immunology** , University of Alberta and KMT Hepatech Inc.#, Edmonton, Alberta, T6G 2E1, Canada INTRODUCTION Study 2: Effect of protease inhib