Pain, pain, go away: Why you shouldn't take over-the-counter painkillers lightly
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Pain, pain, go away: Why you shouldn't have over-the-counter painkillers lightly
Other than allergic reactions (yes, even from paracetamol), y'all tin also increment your run a risk of liver impairment. CNA Lifestyle looks at the different misconceptions regarding painkillers.
(Photo: Pexels/Anna Shvets)
02 Sep 2022 06:30AM (Updated: 09 Aug 2022 02:44PM)
People use painkillers – both over-the-counter and prescribed – for reasons that range from everyday situations (headaches, fever, menstrual cramps, arthritis and musculoskeletal aches) to specific ones (nerve harm, trauma injuries and surgery).
And it'due south not only paracetamol (normally sold nether Panadol) that is available on the shelves and kickoff in line for doctors to prescribe, said general practitioner Dr Jonathan Ti from DTAP Dispensary Robertson. In that location are as well non-steroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen, aspirin and naproxen, which are sold nether brands such every bit Nurofen, Alka Seltzer and Aleve respectively.
At the polyclinics, the commonly prescribed painkillers include paracetamol, paracetamol combined with a muscle relaxant, and NSAIDs, said Christina Lim, the assistant manager of chemist's shop at SingHealth Polyclinics. Another selection is paracetamol combined with low-dose codeine (an opioid painkiller) but it is only available after a pharmacist'south cess, she said.
While in that location are no topical paracetamol products bachelor in Singapore, there are NSAIDs available as gels or patches. These include ketoprofen gels (nether brands such as Fastum) and plasters (under the Kenhancer make), said Lim.
Speaking of topical painkillers, there are besides the counter irritants and local anaesthetics, which yous can go without a prescription, said Yong Pei Chean, the president of the Pharmaceutical Society of Singapore (PSS), on behalf of the PSS squad.
READ: Headaches: When should yous take a painkiller or see a doctor?
Counter irritants (under brands such equally Tiger Balm and Ammeltz Yoko Yoko) by and large contain ingredients such as capsaicin, menthol and camphor. After applying on the skin, a warm or cool sensation can be felt, which distracts you from the actual pain, she explained.
On the other hand, local anaesthetics, such as lignocaine, can exist found in clarified creams and gels. "When these are applied, it temporarily numbs the area and reduces the power of nerves to transmit pain sensation," said Yong, who is likewise the pharmacy head of the upcoming Woodlands Health Campus.
Now, because painkillers are so readily bachelor – even minors who tin't buy booze and cigarettes can access them – at that place'south a greater likelihood for people to regard them lightly. Here's a expect at some of the common misconceptions about over-the-counter hurting relief and how these tin actually work confronting you lot.
MISCONCEPTION #one: IBUPROFEN WORSENS COVID-19 SYMPTOMS
If y'all've been following the news, you lot'd take come beyond reports on NSAIDs, specifically ibuprofen, worsening the symptoms of COVID-19 infections such as fever. "In early March, health authorities in France put out a alarm on the employ of ibuprofen in patients with COVID-19 based on unconfirmed anecdotal reports that severe COVID-nineteen cases had been exposed to this medication," said Dr Ti.
READ: Born in the 70s or 80s? Your vaccination jabs might have expired
"However, numerous studies and analyses take since been washed with ibuprofen and other NSAIDs, which demonstrate in that location is no increased gamble for people using NSAIDs to develop a more severe COVID-xix infection in comparing to those taking paracetamol, or other painkillers or fever medications," he said.
The issue has besides been addressed by health organisations, including the World Health System and the Ministry of Wellness in Singapore.
Dr Koh Kim Hwee, the clinical atomic number 82 for SingHealth Polyclinics' Musculoskeletal Workgroup, said that on the whole, "ibuprofen is yet a safe and useful painkiller, and it may be used equally an option in treating fever and/or pain in patients with suspected or confirmed COVID-19". "As with other NSAIDs, the lowest effective dose should exist used for the shortest flow required to control the symptoms if needed."
In fact, NSAIDs can be your alternative if you are allergic to paracetamol, said Yong. As the name indicates, this category of drugs relieves hurting by reducing swelling, redness and warmth. In addition to ibuprofen and naproxen, NSAIDs also include diclofenac, mefenamic acrid, celecoxib and etoricoxib.
But unlike paracetamol, which is generally amend tolerated, NSAIDs may not be suitable for anybody.
"NSAIDs are known to take some claret-thinning effects and may increase one's adventure of bleeding, peculiarly when it is taken together with medicines or herbal supplements that have similar properties," cautioned Yong, referring to the claret thinner warfarin, and herbs such as ginkgo and ginseng.
You should also check with your dr. first before popping NSAIDs if you are under sixteen or over 65 years old, significant or trying for a infant, breastfeeding, asthmatic, had previous tummy ulcers or allergies to NSAIDs, have issues with the heart, liver, kidneys, blood pressure, circulation or bowels, and/or taking other medicines, noted the National Health Service (NHS) in the UK.
NSAIDs are usually taken once or twice a day and the tablets should be swallowed whole (not crushed or chewed, unless otherwise told by your doc) and taken after nutrient to prevent stomach upset, advised SingHealth.
MISCONCEPTION #2: Information technology'S OKAY TO TAKE PAINKILLERS WITH OTHER MEDICINES
Unknowingly overdosing on painkillers can happen when you are non aware of, or are unfamiliar with the ingredients in the medicine.
"For instance, a patient may be taking Anarex, which contains paracetamol and orphenadrine, for chronic hurting. If he purchases Panadol Cold Relief (information technology too contains paracetamol as well as phenylephrine) to cocky-medicate and save symptoms of the flu, he could unknowingly exist overdosing on paracetamol," said Yong.
READ: Over-the-counter cough mixtures: Do they actually piece of work improve than tea and honey?
"This often occurs when medications are obtained from dissimilar sources, such as when they are prescribed by two dissimilar doctors or pharmacists."
Overdosing can also occur when yous aren't enlightened of the painkiller's strength, which happens very normally in children, said Yong.
"A kid may be previously prescribed with 5ml of a 120mg/5ml preparation past a md. Should the parent subsequently purchase a 250mg/5ml training and give the child 5ml as per the previous medico'southward prescription, the kid will be given double the dose."
In the start place, getting the dose right for children tin exist tricky as it is more than accurately determined based on the child's weight, said Yong. "Nevertheless, weight-based dosing information may not always exist nowadays on the packaging. Furthermore, patients who are underweight, elderly, or have existing kidney or liver bug, are also at a higher risk of overdose."
MISCONCEPTION #3: TAKE A Petty More TO SUBDUE THE Pain FASTER
It doesn't piece of work that style, said Dr Ti. "Different medications will take dissimilar onset and duration of action timings. Oral paracetamol and ibuprofen by and large start working within thirty minutes, and furnishings last about six to viii hours."
The same medicine can be formulated differently and that can also impact the duration of activeness, said Yong. For example, diclofenac'due south sustained release may last for up to 24 hours and is taken once a day, while diclofenac immediate-release tablets can concluding only eight to 12 hours, and may be taken two or iii times a twenty-four hour period.
Moreover, taking more painkillers than yous should can wreck your liver. For instance, you should not exceed eight 500mg tablets of paracetamol in a day, according to Yong. Over-dosing and liver injury tin can likewise occur with just a single ingestion of 10g or 200mg per kilogram of your trunk weight (whichever is less) inside an eight-hour period, even without long-term consumption.
"For paracetamol overdose, symptoms may include nausea, vomiting, sweating, and changes in mentation (mental activity)," said Dr Ti.
The signs of overdosing on NSAIDs are more severe, including acute kidney injury and/or bleeding in the stomach or intestines, said Yong. "This bleeding may present every bit nausea and airsickness, blood in the vomit, or as black, viscid stools with or without sharp gastric pain."
The long-term use of NSAIDs is besides associated with long-term tummy pain, ulcers in the stomach and intestines, and can increase the risk of centre affliction, she said.
If you suspect an overdose, caput directly for the hospital emergency centre, advised Dr Ti. "They volition require specific treatment protocols and close monitoring, which would non be available at a regular GP."
"It can be helpful to bring along the box or leaflet of the medication the patient has been taking to assist the medical squad accurately identify the cause of the overdose," suggested Yong.
MISCONCEPTION #4: It'Southward JUST A PAINKILLER. NO Damage CAN Come up FROM TAKING Information technology
Not true as some individuals can be allergic to paracetamol. For instance, if yous discover reactions such as rashes, swelling of the eyes and lips, and/or difficulty breathing after taking paracetamol, terminate and see a doctor immediately.
Yous might also want to avoid paracetamol if you regularly drink more than 14 units of alcohol per week, have kidney or liver problems, and/or are on epilepsy medicine, according to the NHS. In fact, some medications may even interact with nutrient, said Lim, and so it'southward best to consult a chemist or doctor before starting on any new medication, even if it is an over-the-counter 1.
NSAIDs, on the other hand, may cause common side effects such as dizziness, nausea, gastric irritation and increased blood pressure, according to SingHealth. You lot should also expect out for the less common side effects such as fluid retention and/or worsening asthma.
When it comes to the dosage, accept your cue from the packaging, especially for NSAIDs, as their dosages differ. For paracetamol, SingHealth recommended one to ii tablets, three or four times daily for patients who are 12 years onetime and beyond. Do not take more than two tablets at whatsoever time and ensure each dose is at to the lowest degree four hours apart.
What if you have to regularly accept paracetamol and miss a dose? Take it as soon as you think, advised the NHS. Yous can skip the missed dose if it's well-nigh time for your adjacent dose. Withal, do non take an actress dose to make up for a missed one. The same applies to NSAIDs, too.
"When in doubt, it is advisable to consult the physician or chemist for advice," said Yong. "This is particularly of import if one has any medical atmospheric condition, is on long-term medication, significant, or breastfeeding."
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Source: https://cnalifestyle.channelnewsasia.com/wellness/painkillers-paracetamol-ibuprofen-over-the-counter-medicine-236631
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