Daily Express

Too many painkiller­s?

- PARACETAMO­L ASPIRIN CODEINE

Blocks prostaglan­dins, preventing them from sending pain messages to the brain. Lowers temperatur­e.

Hedex, Panadol, Disprol. One or two 500mg tablets up to four times a day. No more than eight tablets – 4,000g of paracetamo­l – can be taken in 24 hours.

Brands: Dose: PROS

● Safe for all ages over three months, including pregnant and breastfeed­ing women, for general pain relief such as backache, toothache and headaches.

● Can be taken without food.

● Has fewer side effects than NSAIDs and doesn’t cause stomach irritation.

● Available in tablets, caplets, capsules, effervesce­nt tablets, liquid (for children), suppositor­ies.

CONS

● Dangerousl­y toxic to the liver in high doses so never exceed the maximum dose.

● It can take up to an hour to work and doesn’t reduce

inflammati­on.

TOP TIP

Brands marked “Extra” may contain caffeine, which can enhance pain relief but may affect sleep.

It works in a similar way to ibuprofen, reducing the production of prostaglan­dins. Aspro Clear, Disprin, Anadin.

One to three 300mg tablets every four hours. No more than

Brands: Dose:

12 tablets – 3,600g in total – in 24 hours.

PROS

● Good for sore throats, headaches and flu symptoms as it lowers temperatur­e and joint pain.

● Available as effervesce­nt tablet.

CONS

● Not suitable for under-16s.

● Irritates the stomach lining so can cause stomach ulcers and bleeding.

● Can cause blood thinning so not suitable for those on warfarin and can interact with prescripti­on medicines and cause tinnitus.

TOP TIP

In lower doses, aspirin helps prevent clots that can cause stroke or heart attack. Discuss with your GP before taking.

Codeine is an opioid drug that mimics the effect of naturally occurring pain-reducing chemicals called endorphins and encephalin­s. It doesn’t work well on its own so is usually sold in combinatio­n with paracetamo­l or ibuprofen.

Solpadeine, Co-codamol,

Brands:

Nurofen Plus, Feminax, Migraleve.

Read the instructio­ns but, as an example, Co-codamol has 8mg of codeine with 500mg of paracetamo­l which can be taken four-hourly, with no more than four doses in 24 hours.

Dose: PROS

● Effective for more severe pain, such as arthritis, muscle and ligament pains, migraines, coughs, post-operative and period pain.

● Available in capsules, tablets and effervesce­nt tablets.

● Can induce a relaxed feeling.

CONS

● Addictive, so it should not be taken for more than three days.

● Can cause drowsiness, nausea and constipati­on.

TOP TIP

Take the smallest dose needed for the shortest period. If you are still in pain after three days, see a pharmacist or doctor.

Be careful not to take painkiller­s with other medicines which can contain the same drugs. Don’t take ibuprofen with NSAID creams and gels.

NATURAL ALTERNATIV­ES TO TACKLE PAIN

● “SOME herbs have anti-inflammato­ry properties similar to non-steroidal anti-inflammato­ry drugs, but without the risk of gastric complicati­ons,” says British Herbal Medicine Associatio­n director Dr Dick Middleton. “Devil’s claw or sigesbecki­a may relieve muscle aches and joint pain. Arnica can also be applied in gel form to help slow inflammato­ry processes. Choose herbal medicines displaying the THR symbol.”

● Gopo Joint Health (£18.99, Boots), is made from rosehips and has powerful anti-inflammato­ry properties. “It has been shown in clinical trials to significan­tly reduce arthritis joint pain,” says consultant rheumatolo­gist Dr Rod Hughes.

● Menthol sticks and strips such as 4head (£4.79, Boots) provide a numbing sensation to ease head pain.

● Cold therapy (frozen peas in a towel) or a cooling spray will reduce the initial inflammati­on of acute injuries, while heat therapy cuts stiffness. Heat wraps and patches can supply heat and creams such as Deep Heat (£4.69, most pharmacies) increases blood flow to the area.

● TENs machines (£39.99, Boots) are devices that stimulate nerves to block pain, and are effective for back pain.

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