‘Painkillers’ taken despite knowing its harms; what dosage should be taken?

What Is Painkiller or Analgesic

A  Painkiller or analgesic is any member of the group of drugs which is used to effectuate analgesia or relief from pain.

Types of Painkiller

Most pain-relieving medications include one of the following groups:

  • Non-opioid analgesics – e.g. paracetamol 
  • Non-steroidal anti-inflammatory drugs (NSAIDs) – e.g. aspirin, ibuprofen, naproxen, diclofenac 
  • Compound analgesics – e.g. co-codamol, which constitute paracetamol with a dose of an opioid analgesic such as codeine 
  • Opioid analgesics – e.g. codeine, tramadol, morphine (only available on prescription).

Your doctor will usually suggest you try non-opioid analgesics and/or NSAIDs first.

Compound analgesics will usually be the next step for moderate pain if these don’t help, or if you sometimes require stronger pain medications. Opioid analgesics are given for very severe pain.

The reason behind this approach is that the stronger medications lead to more side-effects and can sometimes cause dependency.

Approved and Brand Names

Painkillers may be available under various names. Each drug has an approved name but manufacturers generally give drugs their own brand name too.

Examples of approved and brand names

Approved nameBrand name


Paracetamol is the most popular of a group of drugs called as simple non-opioid analgesics. It is feasible over the counter.

It is often the first treatment people try for mild to moderate pain following a minor injury, or for headaches and muscular pains.

Paracetamol doesn’t have an anti-inflammatory effect, that means generally it is less helpful for inflammatory types of arthritis such as rheumatoid arthritis.

For inflammatory arthritis, paracetamol may be taken jointly with a non-steroidal anti-inflammatory drug (NSAID).

How to Take It?

Generally, paracetamol is taken in doses of two 500 mg tablets, up to four times a day. It is also accessible in a liquid form for children.

Side-Effects and Risks

Side-effects of paracetamol are rare, although a few people may develop a rash.

Paracetamol can impair your liver if you take more than 4,000 mg (eight tablets) in a day. You should be aware that many other products, like cold and flu medicines, also have paracetamol.

There’s been shown that long-term use may affect your cardiovascular system and kidneys.

Compound Analgesics

Compound analgesics are formed from a combination of two different drugs which is generally a standard painkiller such as paracetamol, aspirin or ibuprofen plus a low dose of an opioid analgesic like codeine or dihydrocodeine.

Low dose compound analgesics constituting codeine can be accessible over the counter from pharmacists, but stronger ones are available only on prescription.


  • for moderate pain due to injuries and osteoarthritis
  • as an addition to non-steroidal anti-inflammatory drugs (NSAIDs)

The Common Types of Compound Analgesics

What is it?Codeine (8 mg) and paracetamol (500 mg)Codeine (8 mg) and aspirin (400 mg)Dihydrocodeine (10 mg) and paracetamol (500 mg)
DoseAbout 2 tablets 4 times a dayUp to 2 tablets 4 times a day with foodUp to 2 tablets 4 times a day
Where do I get?Buy them at supermarkets/pharmacies or on prescriptionOn prescriptionOn prescription
most common side-effects





See also side-effects of long-term use of paracetamol











See also side-effects of long-term use of paracetamol

What else should I know?For more severe pain, combinations of 15 mg/500 mg and 30 mg/500 mg are available on prescription.For severe pain, combinations of 20 mg/500 mg and 30 mg/500 mg are available.

Generally,  you will be suggested not to take medicines containing codeine for more than a few days at a time because of its addictive nature.

Side-Effects and Risks

Compounds made from codeine can result:

  • constipation
  • nausea
  • difficulty concentrating

Opioid Analgesics

They are used for moderate to severe pain, generally when other analgesics have not worked. Commonly used opioids are codeine, morphine, and tramadol. Opioid analgesics can be accessible only on prescription from your doctor as they cause more side-effects than simple analgesics and can result in dependency and addiction.

How to take them?

Opioid analgesics are available in a tablet or patch. Your doctor will tell which type is best for you depending on:

  • the severity of your pain
  • age
  • any other medicine that you’re taking.

Side-effects and risks

The most common side-effects are as follows

  • nausea and vomiting
  • constipation
  • drowsiness and dizziness
  • decreased concentration or confusion
  • reduced ability to breath

Written by Anne W. Hansen

Pixie Lott

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