Pain is something everyone experiences, and painkillers, or analgesics, are widely used to help relieve it. In Malaysia, a variety of pain-relief medications are available, and knowing how they work, and their potential side effects can help you use them wisely.
1. Paracetamol (Panadol)
- Group: Non-opioid analgesic
- How it works: Paracetamol reduces pain and fever by acting on the brain to lower the temperature and alter how the body senses pain.
- Common uses: Mild to moderate pain (headaches, muscle aches, toothaches), fever.
- Side effects: Generally well-tolerated, but high doses in short duration of time can cause liver damage.
- Complications: Chronic use or overdose can lead to severe liver failure.
2. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- Examples: Ibuprofen, Aspirin, Diclofenac, Mefenamic acid
- How they work: NSAIDs block enzymes called COX-1 and COX-2, which are responsible for inflammation, pain, and fever.
- Common uses: Arthritis, back pain, menstrual cramps, headache and inflammation-related pain.
- Side effects: Stomach irritation, ulcers, kidney problems, increased risk of bleeding.
- Complications: Long-term use can lead to gastrointestinal bleeding, kidney damage, and increased risk of heart problems.
3. COX-2 Inhibitors (Celecoxib)
- Examples: Celecoxib (Celebrex), Etoricoxib (Arcoxia), Parecoxib
- How they work: These medications specifically block the COX-2 enzyme, which is primarily involved in inflammation and pain, while sparing COX-1 (which protects the stomach lining). This makes them gentler on the stomach than traditional NSAIDs.
- Common uses: Arthritis, chronic pain, headache, and inflammatory conditions.
- Side effects: Can cause stomach discomfort but are generally less likely to cause ulcers compared to other NSAIDs.
- Complications: Long-term use may increase the risk of cardiovascular problems, such as heart attack or stroke, especially in higher doses.
4. Opioids
- Examples: Codeine (in some cough syrups), Tramadol
- How they work: Opioids bind to opioid receptors in the brain and spinal cord, blocking pain signals from reaching the brain.
- Common uses: Moderate to severe pain (post-surgery, injury, cancer pain).
- Side effects: Drowsiness, dizziness, constipation, nausea.
- Complications: Opioid use can lead to dependence, tolerance (needing higher doses), and in some cases, overdose and respiratory depression.
5. Topical Analgesics
- Examples: Diclofenac gel (Voltaren gel), Capsaicin cream
- How they work: Applied to the skin, these medications work by targeting local pain. Diclofenac reduces inflammation, while capsaicin depletes a chemical involved in pain signalling.
- Common uses: Joint and muscle pain (osteoarthritis, sprains).
- Side effects: Skin irritation or redness.
- Complications: Rare, but overuse can lead to skin sensitivity or irritation.
6. Corticosteroids
- Examples: Prednisolone, Dexamethasone
- How they work: These medications mimic the body’s natural steroids, reducing inflammation and immune responses.
- Common uses: Severe inflammatory conditions (arthritis, autoimmune disorders).
- Side effects: Weight gain, mood changes, high blood sugar.
- Complications: Long-term use can cause osteoporosis, high blood pressure, and increased infection risk.
Conclusion
Painkillers can offer great relief, but it’s essential to use them responsibly. Over-the-counter options like paracetamol and NSAIDs are effective for mild pain, while COX-2 inhibitors like celecoxib are often used for chronic conditions with less stomach irritation. Opioids should be reserved for more severe pain under medical supervision. Always consult a doctor or a pharmacist to avoid complications, especially for prolonged use.