About your pain relief

Paracetamol

This is simple pain relief

Ibuprofen

This is a commonly used non-steroidal anti-inflammatory (NSAID)

Aspirin

This is a common pain relief and NSAID

Naproxen

This is another anti-inflammatory pain relief medication

Codeine

This is a weak opioid pain relief (like morphine)

Co-Codamol

This is a combination of Paracetamol and Codeine

Know your regular medicines

You may be advised by the hospital clinician to make some changes to your regular medication. Please make sure that you inform your GP about these changes. You should always carry with you an up-to-date list of your medications. Always tell your doctor if you start or stop medications including those bought over-the-counter and herbal supplements.

Paracetamol 500mg:

Take 1 to 2 tablets, up to 4 times a day

The maximum dose in 24 hours is 8 tablets

Ibuprofen 200mg:

Take 1 to 2 tablets, up to 3 times a day with food

The maximum dose in 24 hours is 6 tablets

Naproxen 250mg:

Take 2 tablets for your first dose

After this, take 1 tablet up to 3 or 4 times a day with food. The maximum dose in 24 hours is 4 tablets

Codeine 30mg tablets:

Take 1 to 2 tablets, up to 4 times a day

The maximum dose in 24 hours is 8 tablets

Paracetamol

What is it?

Paracetamol is a common pain relief medication and is used to prevent or reduce fever. It can be bought in shops. It is safe to take regularly at the dose described.

Dose

• Paracetamol comes in 500mg tablets or capsules.
• The dose for adults (over 16 years old) is 1 to 2 tablets (1000mg).
• Adults who weigh less than 50kg (7.8st or 110lb) should take 500mg.
• At least 4 hours should be left between doses.
• The maximum that you can take is 4 doses (4000mg) in 24 hours.

Who should not take paracetamol?

• If you know you are allergic to paracetamol.
• If you have severe kidney or liver problems.
• If you have a liver problem caused by alcohol.
• Always tell your doctor about all medications you are taking, including herbal medications. This is because paracetamol can affect the way some other medicines work.

Possible side-effects

Like all medicines, paracetamol can cause side-effects. For full details please see the medicine information leaflet inside the medicine box.

If you get a new symptom that you think is related, stop taking paracetamol and speak to your doctor or pharmacist. In an emergency call NHS 111 or 999.

Ibuprofen

What is it?

Ibuprofen is a common pain relief medication and non-steroidal anti-inflammatory (NSAID) and can be bought in shops, sometimes under the brand name Nurofen®.

Dose

• Ibuprofen usually comes in 200mg tablets or capsules.
• The dose for adults (over 12 years old) is 1 to 2 tablets (200 to 400mg).
• At least 6 hours should be left between doses
• Ibuprofen should be taken with food.
• Check the strength of the tablet before taking as occasionally you may be given 400mg tablets - only take one 400mg tablet.
• The maximum you can take is 3 doses (1200mg) in 24 hours.

Who should not take ibuprofen?

• If you know you are allergic to ibuprofen or other NSAIDs.
• If you have ever had gastric ulcers or bleeding from your stomach.
• Ask your doctor before taking if you have bleeding problems, asthma, heart or kidney problems or take anti-platelets or an anticoagulant.
• Always tell your doctor about all medications you are taking, including herbal medications. This is because some medicines can affect the way some other medicines work.
• Ibuprofen can be used during pregnancy before 24 weeks if recommended by your doctor.
• If you are taking ibuprofen for a long time or at risk of getting a stomach ulcer, your doctor may prescribe a medicine to protect your stomach.

Possible side-effects

Like all medicines, ibuprofen can cause side-effects. For full details please see the medicine information leaflet inside the medicine box.

If you get a new symptom that you think is related, stop taking ibuprofen and speak to your doctor or pharmacist. In an emergency call NHS 111 or 999.

Aspirin

What is it?

Aspirin is an everyday pain relief medication also used to reduce fevers and inflammation. It is also known as acetylsalicylic acid. It is used for aches and pains and can also reduce temperature. Some people may be on a low dose of aspirin for heart disease or strokes, this is different to taking higher doses of aspirin for pain relief.

Dose

• Aspirin usually comes in 300mg tablets.
• The dose for adults (over 16 years old) is 1 or 2 tablets.
• At least 4 hours should be left between doses.
• Aspirin should be taken with food.
• The maximum you can take is 12 tablets (3,600mg) in 24 hours.

Who should not take aspirin?

• Never give aspirin to children under 16 years old.
• If you are allergic to aspirin or similar pain relief medications such as ibuprofen.
• If you have ever had gastric ulcers or bleeding from your stomach.
• If you have recently had a stroke.
• Ask your doctor if you have: bleeding problems, high blood pressure, asthma, lung disease, liver or kidney problem.
• Aspirin can make heavy periods and gout worse.
• Avoid using aspirin during pregnancy or breastfeeding.

Possible side-effects

Like all medicines, aspirin can cause side-effects. For full details please see the medicine information leaflet inside the medicine box.

If you get a new symptom that you think is related, stop taking aspirin and speak to your doctor or pharmacist. In an emergency call NHS 111 or 999.

Naproxen

What is it?

Naproxen is a pain relief medication and non-steroidal anti-inflammatory (NSAID). It reduces inflammation and pain in joints and muscles. Naproxen is available on prescription, but you can buy it without a prescription from a pharmacy for period pain.

Dose

• Naproxen usually comes in 250mg tablets.
• The dose for adults (over 12 years old) is 2 tablets (500mg) to start, then 1 tablet (250mg) every 6 to 8 hours.
• At least 6 hours should be left between doses.
• Naproxen should be taken with food.
• The maximum you can take is 4 doses (1000mg) in 24 hours.
• If you are taking naproxen for a long time or at risk of getting a stomach ulcer, your doctor may prescribe a medicine to protect your stomach.

Who should not take Naproxen?

• If you are allergic to naproxen, ibuprofen or other NSAIDs.
• If you have ever had gastric ulcers or bleeding from your stomach.
• Ask your doctor if you have heart problems, asthma, inflammatory bowel disease, lupus, a clotting disorder or you are taking an antiplatelet or anticoagulant.  Naproxen can be used in pregnancy before 24 weeks if recommended by your doctor.

Possible side-effects

Like all medicines, naproxen can cause side-effects. For full details please see the medicine information leaflet inside the medicine box.

If you get a new symptom that you think is related, stop taking naproxen and speak to your doctor or pharmacist. In an emergency call NHS 111 or 999.

Codeine

What is it?

Codeine is a moderately strong pain relief that is only available on prescription. For most people, it is safe to take regularly at the dose described for a short period of time. Taking codeine for longer than 3 days can cause addiction and so should be monitored by your GP.

Dose

• Codeine comes in 15mg or 30mg tablets.
• The dose for adults (over 12 years old) is 1 or 2 tablets.
• At least 4 hours should be left between doses.
• The maximum that you can take is 4 doses (240mg) in 24 hours.
• It is important to take paracetamol and/or ibuprofen regularly and only take codeine if you are still in pain.

Who should not take codeine?

• If you know you are allergic to codeine.
• If you have breathing problems such as COPD or sleep apnoea consult doctor before taking.
• If you have been told you are an “ultra-rapid metaboliser” of codeine or morphine.
• Consult your doctor before taking if you are pregnant.
• If you are breastfeeding.

Possible side-effects

Lots of people get side-effects with stronger pain relief medication. The most common side-effect with codeine is constipation (not opening your bowels often, difficulty opening your bowels). It is recommended that you increase the fibre in your diet (such as eating prunes) and if needed take a laxative such as senna.

Some people also report nausea (feeling sick), vomiting and drowsiness. If you feel sleepy when you take codeine do not drive or operate machinery.

For full details about the side-effects please see the medicine information leaflet inside the medicine box.

If you get a new symptom that you think is related, stop taking codeine and speak to your doctor or pharmacist. In an emergency, call NHS 111 or 999.

Co-codamol 8/500, 15/500 or 30/500

What is it?

Co-codamol tablets contain two medications: paracetamol (500mg) and codeine (either 8mg, 15mg or 30mg). The weaker strength can be bought over-the-counter but the stronger dose has to be prescribed.

Reference

https://www.nhs.uk/medicines/

https://bnf.nice.org.uk/drug