Know Your Medicine: Types of Painkillers


Popping a painkiller is one of the most common ways to treat pain at home. Right from toothache and period pain to arthritic pain, painkillers are the most effective solution. However, using these medicines more often than not is not a good idea as it might lead to health complications and side-effects. Here’s more on the types of painkillers, their mechanism and common side-effects (if any) you need to know.

Types of painkillers

There are three common types of painkillers:

1. Paracetamol

Also known as acetaminophen, paracetamol is one of the commonly used analgesics to control fever. However, this medicine is also used to relieve pain along with being the first line of treatment for high body temperature.

How it works: The exact action mechanism of this class of drug is still debated. However, it is believed to inhibit the synthesis of prostaglandins in the central nervous system (CNS). Prostaglandins are hormones which are released at the site of injury or infection and play a key role in controlling inflammatory response.

Side-effects: It is one of the best tolerated medicines. However, side-effects such as allergies are reported in certain cases. But an overdose of this medicine can lead to liver damage (hepatotoxicity).

Hence, always consult your doctor before taking this medicine to know the right dosage and prevent its side-effects.

2. Non-steroidal anti inflammatory drugs (NSAIDs)

NSAIDs are the common painkillers which reduce pain, fever and inflammation. But unlike other anti-inflammatory medicine, they do not contain steroids. These medicines are the largest group of over the counter painkillers which are used to treat different types of pain like headache, period pain and toothache.

How it works: NSAIDs inhibit the action of the enzymes known as cyclooxygenases or COX enzymes, which play a key role in the production of prostaglandins. However, these drugs are non-specific in their action.

Side-effects:  The main safety concerns to be aware of when using NSAIDs are complications with gastrointestinal tract, kidney, heart, blood, liver and allergic reactions. This is mainly because these drugs inhibit the action of COX-1 enzyme which affect the GI tract. Moreover, these drugs can interact with various medicines.

These drugs are commonly used as over the counter (OTC) medicines to treat pain and fever. However, taking NSAIDs is shown to increase the incidence of heart attack and stroke. Hence, avoid using these drugs without your doctor’s advice.

3. Opioids

Opioids are undoubtedly one of the strongest analgesics available in the market. These are commonly used to treat moderate to severe pain which could be acute or chronic. It is also used to fight pain during cancer treatment. Tramadol is one of the most commonly used drug to treat moderate to severe pain, especially for long-term pain relief.

How it works: This class of drugs acts by suppressing the neurotransmission in the central nervous system, which helps in alleviating pain. This is achieved due to the binding of the drugs to the opioid receptors, more specifically μ receptor, present in the brain.

Side-effects: The use of opioids have increased significantly over the last decade and thus, the frequency of adverse drug reactions. The most common side effects of opioids include constipation, nausea, vomiting, sedation, urinary retention, pruritus and depression.

As these drugs are mostly used to manage chronic pain, the risk for opioid dependence, leading to its abuse and misuse, has increased. This is why you check with your doctor about the pros and cons of these drugs before use to prevent dependence on these drugs.

(The article is reviewed by Dr. Ashish Ranjan, General Physician)

Recommended Reads:

How To Store Medicines Properly

Know Your Medicines: Antibiotics


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pain. Anesth Prog. 2010 Summer;57(2):67-78; quiz 79-80. 

NCBI. Using medication: The safe use of over-the-counter painkillers.

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