Pain Medication

Pain Medication

Pain relief at home
This advice leaflet discusses the three type of analgesics (painkillers) commonly used in the emergency department to help you manage your pain effectively at home. The type and amount of pain relief medication we prescribe will be different for everyone, as everyone feels pain differently. Acute pain is a short-term pain that is caused by something specific, such as an operation, injury, or illness. It can be severe, but it usually gets better quite quickly (within a few days or weeks)

Common pain relief medications

Paracetamol
Paracetamol is an excellent pain relief medication that has very few side effects. It is usually the first pain relief medication you will be advised to take and the last one to stop. Do continue to take paracetamol even if you are prescribed stronger pain killers, as it also helps to improve the effect of other pain relief medications. Don’t take paracetamol with other medications containing paracetamol, such as co‑codamol, co-dydramol, or cold and flu treatments, as there is a risk of overdose. Paracetamol is easily available and inexpensive and does not require a prescription.

Paracetamol can be taken regularly if you are in pain. The usual dose for adults is one or two 500mg tablets up to four times in 24 hours. The maximum dose is 4g (eight tablets) in 24 hours, assuming you weigh over 50kg. You must always leave at least four hours between doses.

Anti-inflammatory painkillers
Anti-inflammatory medications may be used in-addition to paracetamol and can provide good pain relief. Examples of anti-inflammatory medications include ibuprofen, naproxen, diclofenac, and mefenamic acid. You should not use anti-inflammatory medications if you have severe asthma, kidney problems, or are at an increased risk of bleeding or stomach ulcers. If you have heart disease or are taking blood thinning medicines speak to the doctor or pharmacist before taking anti-inflammatory medications. These types of medications are not usually recommended if you are trying to get pregnant or are breast feeding. You should take anti-inflammatory medication with food and discuss with your GP if you require them for more than 2 weeks. Ibuprofen is easily available and inexpensive and does not require a prescription.

The usual adult dose of Ibuprofen is 400mg three times a day; Naproxen 250mg three to four times a day; Mefenamic acid 500mg three times a day.

Codeine
Codeine is an opiate (like morphine) and a strong pain killer that works well for short-term acute pain. This type of medication (opioid) should only be taken for a short period of time, as the longer it is taken, the less effective it becomes at managing pain. Opioid medications may also have significant side effects that become more severe the longer they are used, or if the dose is increased. Common side effects of opioid medications include: nausea (feeling sick), vomiting (being sick), itching, constipation, and drowsiness. Less common side effects include hallucinations and addiction.

Do not drink alcohol while taking opioid medication as this may cause excessive and dangerous drowsiness. Due to the potential side effects and reduced effectiveness, opioid medications should be stopped as soon as your pain improves. If you need additional opioid medications after discharge, you will need to contact your GP. Your GP or local pharmacist will also be able to offer advice on constipation and laxatives. Opioid medications may affect your ability to drive.

The usual dose of codeine is 30-60mg to a maximum of four times a day.

Can I take more than one pain relief medication at the same time?
Yes, as long as you are not taking two of the same type of pain killer, e.g. ibuprofen and naproxen.

How should I stop taking my pain relief medications?
If you have been taking a combination of paracetamol, anti-inflammatory, and codeine regularly, do not stop all of them suddenly. You should keep taking paracetamol regularly while you gradually stop the codeine first, and then the anti-inflammatory medication. Pain can often feel worse at night as there is less to distract you from the feeling. If this is the case, stop the daytime doses first and continue to take pain relief medication at night until you feel ready to stop these doses.

Can I drive while taking pain relief medications?
It’s an offence to drive a car if your ability to drive safely is affected by drugs. It’s your responsibility to decide if it’s safe to drive. If you are advised by a medical professional not to drive, you are legally obliged to follow that advice.
Certain factors may affect your driving ability, including

• starting (initially) or increasing the dose of a pain relief medication
• drinking alcohol while taking pain relief medication

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net
Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.
If you are unable to understand this leaflet, please communicate with a member of staff.

For additional medical advice, if your symptoms or condition worsens:
Contact your GP
NHS 111: Telephone 111
Get help with your symptoms, NHS111: https://111.nhs.uk/
Information to help you manage your health: www.nhs.uk
In an emergency telephone 999

Version 1