Even though non-prescription pain relievers are widely available, they are still medicines, and can have serious side effects. Before using a pain reliever, consider if there may be a better way to relieve your pain, such as relaxing and managing stress, using a hot or cold pack, or being more active. If you do decide to use a pain reliever, take only the recommended dose.

Main types

The most common active ingredients in non-prescription pain relievers are paracetamol, anti-inflammatory agents and codeine. The active ingredient is the chemical in the medicine that makes it work as intended.

Paracetamol

Paracetamol relieves pain and a high temperature. It is found in many pain relieving medicines, either on its own or combined with another active ingredient, such as codeine or caffeine.

 

When used at the recommended dose, paracetamol is safe and rarely causes side effects.
However, it can cause serious liver damage and even death when used at more than the recommended dose.

Paracetamol is also found in many other non-prescription medicines, including many cold, cough and flu medicines. When using such medicines, check the label of the other medicines you are using to make sure that you are not accidentally taking two doses of paracetamol.

Anti-inflammatories

Aspirin, ibuprofen and naproxen belong to a group of medicines called nonsteroidal anti-inflammatories (NSAIDs), but commonly referred to as anti-inflammatories. Other anti-inflammatories of this type include benzydamine, diclofenac, ketoprofen, mefenamic acid and piroxicam.

Anti-inflammatories relieve pain, reduce inflammation and swelling, and relieve a high temperature.

They come in many different forms, including tablets, capsules, creams, gels and mouthwashes. Many contain only one active ingredient, but some are sold in combination with another active ingredient, such as paracetamol or codeine.

 

Paracetamol is found in many non-prescription medicines,

including many cold, cough and flu medicines.

 

Anti-inflammatories are more likely than paracetamol to cause side effects, especially in people with some chronic conditions, people taking certain other medicines, and people over 65 years of age. Common side effects include nausea, heartburn and indigestion. More serious side effects include stomach bleeding and kidney problems.

 

Recent research also suggests that someanti-inflammatories can increase the chance of heart attacks and strokes. They can also cause problems during pregnancy.

Codeine

Codeine is only available without a prescription in combination with another active ingredient, such as paracetamol, ibuprofen or aspirin. It can create dependency, so medicines containing codeine are kept behind the pharmacy counter, and can be bought only after talking to a pharmacist.

Selecting a pain relieving medicine

Paracetamol is usually the best pain medicine for mild to moderate pain, because it has fewer side effects when used at the recommended dosage. If paracetamol does not relieve your pain adequately, talk to your doctor or pharmacist. They may be able to suggest another medicine for you.

If you have a chronic condition, are using other medicines, or are over 65 years of age, talk to your doctor or pharmacist before using any pain reliever. If you are pregnant, you should not use anti-inflammatories in the last three months of pregnancy.

Some pain medicines are available in forms that can be more easily used by people who have difficulty swallowing tablets and capsules. For example, some are available as a liquid, suppository, cream or gel. Talk to your pharmacist about suitable products.

Some pain medicines have similar names that can be confused with each other. Before buying any pain medicine, read the packaging to check that it contains the right active ingredient. Also, check the other non-prescription medicines you are taking to make sure they don’t contain the same active ingredient. If in doubt, talk to a pharmacist.

Use as directed

As with any other medicine, use only the dose recommended on the packaging. Using less may mean that the medicine does not relieve your pain. Using more won’t usually give you better pain relief, but could result in serious side effects. Take particular care when giving pain relieving medicines to babies and children, and make sure you don’t give them more than the recommended dose.

Seek medical advice

If a pain reliever does not relieve your pain or your pain lasts more than 2–3 days, seek advice from your doctor or pharmacist.

Examples of over-the-counter pain relievers

Active ingredient	Brand name includes
Paracetamol	Anagraine, Chemists Own Paracetamol, Dymadon, Febridol, Herron Paracetamol, Panadol, Panamax, Parahexal, Paralgin, Setamol, Tylenol
Anti-inflammatories
Ibuprofen	Advil, Brufen, Brugesic, Chemists Own Ibuprofen, Herron Blue, Nurofen, Panafen, ProVen, Rafen, Tri-pofen
Aspirin	Aspro, Aspro Clear, Bayer Aspirin, Cartia, Disprin, Herron Aspirin, Solprin
Naproxen	Aleve, Chemists Own Period Pain, Naprogesic
Mefenamic acid	Ponstan
Diclofenac	Chemists Own Diclofenac, Voltaren,
Piroxicam	Feldene
Benzydamine	Difflam
Ketoprofen	Orudis
Products with more than one active ingredient
Paracetamol with caffeine	Panadol Extra
Paracetamol with codeine	Codalgin, Codalgin Plus, Codapane, Codral Pain Relief, Dolaforte, Febricod, Fiorinal, Hexal Comfarol Plus, Mersyndol Day Strength, Panadeine, Panamax Co, Prodeine
Ibuprofen with codeine	Nurofen Plus, Panafen Plus
Aspirin with codeine	Aspalgin, Codiphen, Codis, Disprin Forte, Veganin

This list does not include all brands available in Australia.