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Analgesics

Analgesics are medications that are prescribed or bought over the counter that control pain symptoms.

  1. Analgesics are also known as painkillers
  2. Some are bought over the counter while others are only available with a prescription
  3. Stronger pain treatments may require monitoring from a doctor

If you are concerned about any pain you are experiencing, you can speak with one of our registered clinicians via our online video consultation service. Our clinicians are available from 9.30am to 4.30pm, five days a week. 

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Product information

What are analgesics?

Overdosing on painkillers is dangerous and you should seek immediate medical attention if this occurs. 

Analgesics describe the many forms in which painkillers come in. Pain can be caused by a great variety of conditions and injuries, with each analgesic designed to treat the specific type of pain you may be experiencing. For example, prescription strength painkillers can be used for mild to moderate non-nerve pain.

Painkillers

Paracetamol is commonly used to treat headaches and other non-nerve related pains. It’s available to buy over the counter, and may also be effective at reducing fevers. It’s regularly found in cold and flu medications, and one or two 500mg tablets can be taken up to four times a day. It is one of the milder forms of painkiller and is generally well tolerated. It takes around one hour to have full effect. 

Non-steroidal anti-inflammatory drugs

NSAIDs stands for non-steroidal anti-inflammatory drugs. These medications range from over the counter types, such as ibuprofen and aspirin, to prescription medications for arthritis, such as naproxen. NSAIDs are not only prescribed as a painkiller, but for many different conditions where inflammation is present, including inflammatory bowel disease and cardiovascular problems. Unlike painkillers, stronger NSAIDs can cause side effects, and may not be suitable for people with other conditions such as asthma. Some NSAIDs can be bought in gel form for injuries and muscle pain, which take a day or two to have effect. Typically however, you should experience benefits within half an hour of consumption.

Codeine, like NSAIDs, is available over the counter and via a prescription. As a painkiller, it’s most effective when it is combined with others. Stronger forms of the drug can be given at hospitals and prescribed by your doctor, but long-term use is not recommended, as it can be addictive. It can treat coughs triggered by colds and flus, as well as diarrhoea, and it’s usually taken four times a day, in dosages ranging between 15mg and 60mg. It’s also available in liquid form or as an injection. 

Nerve painkillers

Nerve painkillers come in a few different forms, with each medication well suited to the specific cause and severity of the pain. Amitriptyline is typically prescribed to treat depression, but has been shown to be highly effective for back pain, neuralgia (nerve pain in the face) and as a preventative measure against migraines. It can take up to six weeks to effectively treat pain, but many people notice benefits within the first few weeks. 

Gabapentin is primarily an epileptic medication, but has been shown to be highly effective for certain types of nerve pain, such as nerve damage from shingles and diabetes. It may also be prescribed to treat migraines. It usually takes a few weeks before it’s effective at treating pain symptoms, however.

Opioids

Opioids are the most powerful painkillers, but also the ones that come with the most serious risks. As such, they should only be prescribed to treat the most severe symptoms of pain. They are available in many different forms, such as a patch, injection or pump, but prescriptions will likely come in tablet form. Some of the most common forms are morphine, oxycodone, fentanyl and tramadol. Because these drugs can be addictive, the risk of overdose is increased, and you will need to be carefully monitored by your doctor. These risks are magnified when taken long term, as you will likely need to increase the dosage in order to maintain the medication’s effects. As such, where possible, other treatments will likely be considered first.

Should you need advice on pain management, our registered clinicians are available to speak with from 9.30am until 4.30pm, five days a week, via our online video consultation service. They may also be able to provide access to specialists and fit notes where suitable. 

Page last reviewed:  18/06/2020
Side effects and warnings

Can analgesics have side effects?

All medications come with risks of side effects, the risks of which should be understood before starting treatment. Each type of analgesic comes with its own side effects, which range from mild and rare to serious and more common.

Painkillers

Side effects for painkillers are usually rare and mild, and they are available over the counter. 

If you notice any of the following symptoms of an allergic reaction, seek immediate medication attention: swelling of the hands, feet, ankles, face, lips or throat that makes swallowing or breathing difficult, hives or urticaria. If any of the following present for more than a few days, speak to your doctor: bruising more easily, frequent infections. These symptoms have only ever been reported a few times, however, and as such are very unlikely to occur.

NSAIDs

The most common NSAIDs  are relatively mild, which means they are less likely to cause side effects.

Side effects include:

Common (affects up to 1 in 10 people): Dizziness, fatigue, diarrhoea, wind, constipation and headaches.

Uncommon (affects up to 1 in 100 people): Drowsiness, anxiety, pins and needles, difficulty sleeping, hives, sensitivity to light, hearing problems, sneezing, rhinitis, stomach or gut ulcers, inflammation of the stomach lining, tinnitus, vertigo and mouth ulcers.

Rare (affects up to 1 in 1000 people): Depression and confusion. 

Very rare (affects up to 1 in 10,000 people): Inflammation of the pancreas.

Stronger analgesics

Side effects may include:

Common: drowsiness, nausea, vomiting, constipation and sweating.

Less common: dizziness, feeling faint on standing up, small pupils, blurred vision, double vision, mental clouding or confusion, depression, euphoria, hallucinations, nightmares, headaches, vertigo, facial flushing, difficulty breathing, stomach cramps, sweating, dry mouth, difficulty or pain in passing urine, passing less urine than usual, biliary spasms, palpitations, raised intracranial pressure, hyperglycaemia, pancreatitis, feeling tired, hypothermia, fever, an enlarged spleen or swollen/enlarged lymph nodes, anorexia, muscle spasms or rigidity,  slower or faster pulse, skin rash, itching, reduced sexual drive or impotence.

Nerve painkillers

Nerve painkillers are available in numerous forms, and so the side effects associated with them may vary greatly. 

Very common (affects more than 1 in 10 people): sleepiness, shaking of the hands or other body parts, dizziness, headache, irregular heartbeat, low blood pressure, dry mouth, constipation, nausea, excessive sweating, weight gain, slurred or slow speech, aggression and congested nose.

Common (affects up to 1 in 10 people): confusion, sexual disturbances, disturbance in attention, changes in taste, numbness or tingling in the arms or legs, disturbed coordination, dilated pupils, heart block, fatigue, low sodium, agitation, urination disorders and excessive thirst.

Uncommon: (affects up to 1 in 100 people): excitement, anxiety, difficulties sleeping, nightmares, convulsions, tinnitus, increased blood pressure, diarrhoea, vomiting, skin rash, nettle rash, swelling of the face and tongue, difficulties passing urine, increased production of breast milk, pressure in the eyeball, collapse conditions, worsening of cardiac failure and liver function impairment. 

Rare (affects up to 1 in 1,000 people): reduced appetite, delirium, hallucinations, abnormality in the heart's rhythm, swelling of the salivary glands, hair loss, increased sensitivity to sunlight, breast enlargement in men, fever, weight loss and abnormal results of liver function tests. 

Very rare (affects up to 1 in 10,000 people): heart muscle disease, restlessness, disorder of the peripheral nerves, increase of pressure in the eye, abnormal heart rhythm, allergic inflammation of the lung alveoli and of the lung tissue.

The following side effects have been reported but their frequency has not been established: loss of appetite, increased or reduced blood sugar levels, weakness, poor concentration, disorientation, delusion, restlessness, pain, poor co-ordination, blurred vision, dry eyes, paranoia, involuntary movements, hypersensitivity, inflammation of heart muscle, heart attack, stroke, hepatitis, hot flush, stomach pain, sore mouth, black tongue, breast enlargement, changes in sex drive or function and ADH secretion changes.

Prescription pain relief

Side effects and health risks associated with prescription pain relief are more serious than with other analgesics, so more care will need to be taken with their application. Side effects include:

Common (affects up to 1 in 10 people): drowsiness, feeling sick or being sick, constipation and dizziness.

Other known side effects include: sweating, feeling faint on standing up, small pupils, blurred vision, double vision, mental clouding or confusion, mood changes, euphoria, a feeling of emotional and mental unease, hallucinations, headache, vertigo, facial flushing and dry mouth, difficulty or pain in passing urine, passing less urine than usual, biliary spasm, palpitations, slower or faster pulse, skin rash, wheals, itching, reduced sexual drive or impotence, muscle twitching and an increased sensitivity to pain.

Page last reviewed:  18/06/2020
Questions and Answers

Can I consume alcohol during treatment with analgesics? 

It depends on the type of painkiller you’re taking. Alcohol should not cause any issues when consumed with painkillers, but should be avoided if you are taking pain medication. If you’re unsure, speak to your doctor.

Are painkillers safe to take during pregnancy or while breastfeeding?

It depends on the type of analgesic you’re taking. Speak with your pharmacist or your doctor if you are pregnant, thinking of becoming pregnant or are breastfeeding, before starting treatment.

Will analgesics impair my ability to drive?

Some painkillers affect your judgement or focus when using them. For example, pain medication is likely to cause drowsiness. It is illegal to drive if your ability has been affected by any drug, including prescription medications, so be sure to see how your treatment is affecting you before operating any heavy machinery.

Can I buy analgesics over the counter?

Some painkillers are available to buy over the counter at your local pharmacy, supermarket or convenience stores, although there are limits to the amount you can buy at once. Stronger painkillers, and  nerve painkillers, for example, are prescription only treatments. 

How do I buy analgesics online?

If you would like to speak to a GPhC-registered clinician about analgesics, you can do so via our online video consultation service. They are available from 9.30am to 4.30pm, Monday to Friday.  Our clinicians may also issue referral to specialists for treatment and fit notes, where appropriate. 

Page last reviewed:  18/06/2020

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