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Analgesics (painkillers)

Analgesics (Paracetamol, Aspirin, Ibuprofen, Codeine)

Analgesics (also simply known as painkillers) are a broad class of medications used to treat the symptoms of pain. They work by dulling or blocking pain signals to the brain, however, they do not change the cause of the pain. They usually come in the form of oral tablets or capsules that can be taken as needed, or as a regular dose (preferably under medical supervision) up to a maximum daily limit.

Common analgesics include paracetamol and aspirin. These are available over the counter (OTC) through supermarkets or pharmacies.

Some analgesics also have anti-inflammatory properties and are referred to as nonsteroidal anti-inflammatory drugs (NSAIDs). Examples of these include meloxicam (Mobic®) and celecoxib (Celebrex®). Aspirin and ibuprofen are also classed as NSAIDs, but paracetamol is not, as it has limited anti-inflammatory benefits.

Paracetamol and aspirin can be combined with various other drugs, such as some opioid products (including Panadeine Forte®) or NSAIDs to increase pain relief or reduce inflammation. Some of these are available over the counter, but many are only available on prescription (including all products containing codeine), due to their strength and increased risks.

Opioids

Opioids (or narcotics) are a type of analgesic naturally derived from the poppy seed plant. Although derivatives such as opium and heroin have long been used for “getting high”, opioids are now only legally available in Australia for medicinal purposes under prescription — usually to treat moderate to severe pain. Codeine can also be used to treat coughs.

Examples of opioid analgesics include:

  • Codeine
  • Morphine
  • Fentanyl
  • Pethidine
  • Oxycodone
  • Tramadol hydrochloride
  • Buprenorphine (Norspan®)

Codeine and other opioid products are available in different brands, strengths, packs and forms (including tablets, capsules, liquids and topical patches).

Possible Side Effects of Opioids

Side effects of opioids may include:

  • Drowsiness
  • Confusion
  • Constipation
  • Nausea
  • Slowed breathing
  • Euphoria

Australia has very tight regulations related to the prescribing of opioid medications due to the potential for some people to become addicted to them. They also have the potential for accidental misuse due to the sense of confusion and drowsiness they can cause. It is possible for those with chronic pain to take regular doses of opioids to help manage their pain, providing their situation meets the current Australian opioid prescription guidelines.

You and your treating doctor will need to discuss the benefits versus risks of using opioids in your circumstances. This discussion should also cover the other medical and non-medical pain-management options available to help you.

If you and your doctor decide that you are not getting much benefit from opioids or these medications are causing you harm, they will be encouraged to work in partnership with you to safely taper the opioid treatment over time. The aim of this approach is to either stop the opioid medicine or ensure the lowest effective dose is used to effectively treat your pain while minimising the risk of side effects.

 

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For more information about biosimilars, the Therapeutic Goods Administration (TGA), Pharmaceutical Benefits Scheme (PBS) and much more, listen to the relevant episodes of our Patient PrepRheum podcast series or read the transcriptions attached to each episode.