Which painkiller should I take?

They’re readily available without prescription, but knowing which to reach for in different situations will help bring your pain under control fast

Most of us experience pain at some point. Often, it’s a rare event, but for others pain is more frequent or even a chronic, everyday experience. But when a headache, toothache or period pain strikes, which type of painkiller should you reach for, how should you take it and could it be harmful to you? Here’s what to take to combat short-term or ‘acute’ pain.

There are lots of different painkillers – also known as analgesics – available from your local supermarkets or pharmacies. Some are taken orally, while others are creams or gels for topical application.

Paracetamol is one of the most commonly used analgesics. Exactly how it works is not fully understood, but it’s thought to be involved in blocking neurochemical messengers – which tell the brain that you are in pain – and it can also work to bring down a fever.

Most adults can take paracetamol safely, but check with your pharmacist first. The adult dose is two 500mg tablets every four to six hours with a maximum of four doses (eight 500mg tablets) in a

24-hour period. It can take up to an hour to work and can be dangerous if you exceed the dose. It’s often in cold and flu tablets, so check you’re not accidentally doubling up.

Paracetamol is, however, safe to be taken with ibuprofen, which is one of a group of medications called non-steroidal anti-inflammatory drugs (NSAIDS). You can buy it as tablets or as a gel or cream, which you apply topically – direct to the painful area.

Ibuprofen works by preventing the body producing some of the chemicals which cause inflammation, pain and swelling. As such, you may find that it works better than paracetamol for certain conditions, such as period pain or toothache.

If you take it orally, ibuprofen takes approximately 30 minutes to work and the usual dose is 400mg up to three times a day.

Always take ibuprofen with or after food or even with a glass of milk to reduce the risk of developing an upset stomach or heartburn. It may not be suitable for you if you have asthma or have had a gastric ulcer or other conditions, so

‘Check you’re not accidentally doubling up’

check with your pharmacist.

You may also be prescribed a medication to protect your stomach lining if you’re likely to need ibuprofen long-term or are at greater risk of having a gastric bleed. It’s safe to take it at the same time as ibuprofen.

Aspirin is also an NSAID, but can have side effects – such as mild indigestion and bleeding more easily than usual – and tends to be less effective than ibuprofen.

Other available over-thecounter painkillers include low-dose codeine combined with paracetamol. Codeine can have unpleasant side effects including constipation, so do check with your pharmacist first.

And, remember, if you are taking codeine combined with paracetamol, never take it with any other medications which contain paracetamol.