Using pain medicines

Tuesday 1 September, 2015

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On this page: Levels of pain control | How to use medicines | Using medicines safely | Travelling with medicines


Medicines that relieve pain are called analgesics. They do not affect the cause of the pain, but they can reduce pain effectively. The medicine that is best for you depends on the type of pain you have and how severe it is. 

Levels of pain control

There are different types and strengths of pain medicines suitable for different types of pain.

Mild
  • Suitable for pain less than 3 on the pain scale.
  • Examples include paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs).
  • See treating mild pain for more information.
Mild to moderate
Severe

How to use medicines

Take your medicines regularly

Taking your medicines as prescribed is the best way to control the pain. Some people call this ‘staying on top of the pain’. Doing this may mean you can use lower doses of pain relief than if you were to wait until the pain gets worse.

If you think your pain medicine isn’t working, it’s important to let your doctor know as they may need to adjust the dose or prescribe a different medicine.

Give your medicines time to work

Pain medicines may take different amounts of time to work. This will depend on whether the active ingredient is released slowly or immediately.

Slow release medicines

Slow release medicines release the active ingredient continuously to provide pain control for 12–24 hours. They are designed for chronic pain and need to be taken as prescribed. This helps keep the amount of medicine in the blood high enough to be constant and effective.

Immediate release medicines

Immediate release medicines release the active ingredient quickly, usually in less than 30 minutes. They are designed for occasional, temporary pain because they work fast but don’t last.

How quickly different medicines relieve pain also varies greatly from person to person. It depends on how much medicine you take (the dose) and how often you take it (the frequency). 

Understand the different types of pain relief

Pain relief comes in many forms, so you may be taking substances that you didn’t realise were a medicine. Complementary therapies can also help to relieve pain.

Prescription medicines

These are medicines that your doctor must authorise you to take and only a pharmacist can give you (dispense). Most prescription medicines have two names:

  • the generic name identifies the chemical compounds in the drug that make it work
  • the brand name is the manufacturer’s name for the medicine. A medicine may have more than one brand name if it’s produced by different companies. See a list of generic and brand names of strong medicines.
Non-prescription medicines

These are available without a prescription, often from pharmacies and supermarkets, and include over-the-counter medicines such as pain-killers and cold medicines. Vitamin supplements and herbal remedies are also considered non-prescription medicines.

Complementary therapies

These are therapies that can be used with conventional medical treatments to improve your quality of life and wellbeing. Complementary therapies include relaxation, talking therapies, meditation, visualisation, acupuncture, aromatherapy, reflexology, music therapy, art therapy and massage. For more information, see other ways to control pain or read Cancer Council’s booklet Understanding Complementary Therapies.

To manage your pain effectively, you may be given a combination of prescription and non-prescription medicines. You may also want to try complementary therapies to improve your quality of life.

Keep track of medicines

The National Prescribing Service (known as NPS MedicineWise) provides a medicines list to help you record information about what you need to take, when to take it, how much to take and why. The list is available in different formats from nps.org.au.

  • Paper
    Print the Medicines List to keep in your wallet or handbag.
  • Online
    Create, edit and save the Medicines eList as a PDF.
  • Smartphone app
    Download the MedicineList+ app, then scan the barcode on the medicine packaging to add the medicine to the app and set up alarms for taking the medicine.
Discuss your use of pain medicines with family and friends

Family members and friends sometimes have opinions about the pain relief you’re having. Your family members may feel anxious about you taking strong pain medicines. This may be because they are worried that you will become addicted.

Let your family know how the experience of pain affects you emotionally, and that keeping the pain under control allows you to remain comfortable and enjoy your time with them. You may want to ask your treatment team if they can explain to your family and carer why a particular medicine has been recommended for you.

Ways of taking medicines

Pain medicines are taken in several ways, depending on the type of medicine and the form that it is available in. 

tablet or capsule This is the most common form of pain medicine.
liquid
This may be an option if you have trouble swallowing tablets or for convenience.
lozenge
This is sucked on the inside of your cheeks and gums until it dissolves.
injection
A needle is inserted either into a vein (intravenously), into a muscle (intramuscularly) or under the skin (subcutaneously).
skin patch
This is stuck on your skin and gradually releases medicine into the body. The patch only needs to be changed every few days.
subcutaneous infusion
Medicine is slowly injected under the skin using a small plastic tube and a small portable pump called a syringe driver. This can take many hours or days.
intravenous infusion
Medicine is slowly injected into a vein using a small plastic tube and pump over many hours or days. The pump has a button that you press to release a set dose of medicine. This is called patient-controlled analgesia (PCA). It is used in hospitals under the supervision of a pain specialist.
intrathecal injection or infusion Liquid medicine that is delivered into the fluid surrounding the spinal cord. It is commonly used to treat the most severe cancer pain.
suppository
A pellet is placed in the rectum, which dissolves and is absorbed by the body. This may be suitable for someone who has nausea or trouble swallowing.

Using medicines safely

Let your doctor, nurse or pharmacist know if you’re taking any other medicines at the same time as your pain relief. This includes all prescription and non-prescription medicines, vitamins, herbs and other supplements. Different medicines may react with each other, stop a medicine from working properly in the body, or cause dangerous side effects. Some effects to keep in mind include:

  • Many pills for colds and flu, and other over-the-counter medicines, can be taken with analgesics without any harmful effects. However, some over-the-counter medicines, such as paracetamol and anti-inflammatories, contain pain-killers, so a lower dose of pain medicine may be needed.
  • Medicines for colds, menstrual (period) pain, headaches and joint or muscle aches often contain a mixture of drugs, including aspirin. People receiving chemotherapy should avoid aspirin because it increases the risk of internal bleeding. Any minor cuts are likely to bleed a lot and take longer to stop bleeding (clot).
  • Over-the-counter medicines for allergies may cause drowsiness, as can some pain medicines. Taking them together can make it dangerous to drive or to operate machinery. The Therapeutic Goods Administration (TGA) collects information about medicines and medical devices that haven’t worked well. Search the Database of Adverse Event Notifications (DAEN).
Tips for using medicines safely
  • Ask your doctor, nurse or pharmacist for written information about your pain medicines: what they are for, when and how to take them, possible side effects and how to manage them, and any possible interactions with other medicines, vitamins or herbal remedies.
  • Follow directions and ask questions if you need more information.
  • Keep medicines in their original packaging so you and other people always know what they’re for.
  • Store medicines in a safe place that is out of reach of children.
  • Remind yourself when to take your medicines by writing a note, setting an alarm or programming a reminder on your phone. This is safer than leaving your pills out.
  • Let your health care team know of any side effects.
  • Regularly check the expiry dates of medicines. If they are near or past their expiry, see your doctor for a new prescription.
  • Take medicines that have expired or are no longer needed to the pharmacy to dispose of them safely.
  • Check with your health care team whether it is safe to take any complementary therapies, such as nutritional supplements, together with your pain medicine.
  • Find out more about your medicines by calling the National Prescribing Service (known as NPS MedicineWise) Medicines Line on 1300 MEDICINE (1300 633 424).
  • Call the Adverse Medicine Events Line on 1300 134 237, and tell your health care team immediately if you suspect you’ve had a reaction to any kind of medicine. If you need urgent assistance, call 000.

Travelling with medicines

It’s possible to take prescription medicines overseas for your own personal use, but it’s best to follow a few guidelines.

  • Ask your doctor if you need to change your medicine schedule to account for time differences.
  • Make sure you have enough medicines to cover the whole time you’re away, and pack a few extra doses in case you are delayed for any reason.
  • Check with the embassies of the countries you’re visiting to make sure your medicine is legal there.
  • Carry a letter from your doctor or pharmacist outlining what the medicine is, and how much you’ll be taking, and stating that the medicine is for your personal use.
  • Keep medicines in their original packaging so they can be easily identified, and make sure the name on the medicines matches the name on the passport.
  • Ask your doctor if there are limits on the amount of medicines you can take overseas – check online for different countries.
  • Have any medicines you need ready for inspection at the airport. Liquid medicines are exempt from liquid restrictions, as are any icepacks or gel-filled heat packs that are needed to control the temperature of the medicines onboard the flight.

Reviewed by: Dr Melanie Lovell, Clinical Ass Prof, Medicine, Northern Clinical School, Sydney Medical School, University of Sydney, and Palliative Medicine Consultant Physician, Greenwich Hospital, NSW; Nathaniel Alexander, 13 11 20 Consultant, Cancer Council NSW, NSW; Anne Booms, Palliative Care Nurse Practitioner, Canberra Hospital, ACT; Dr Roger Goucke, Consultant, Department of Pain Management, Specialist Pain Medicine Physician, Sir Charles Gairdner Hospital, and Clinical Ass Prof, School of Medicine and Pharmacology, University of Western Australia, WA; John Marane, Consumer; and Dr Jane Trinca, Director, Barbara Walker Centre for Pain Management, St Vincent’s Hospital, VIC.

Updated: 01 Sep, 2015