Taking analgesics—a few precautions for safe use

Analgesics are among the most commonly consumed medications, all categories combined. Therefore, it can be easy to trivialize their use. Yet, as is the case for all medication, the use of analgesics must coincide with certain precautions.

Analgesics—what are they?

Analgesics, sometimes called pain relievers, are well-known by healthcare professionals and by the general public. Widely used, they are stocked in the medicine cabinet of many homes.

By definition, analgesics are drugs that relieve physical pain. Some of them also reduce inflammation (anti-inflammatory properties) or fight fever (antipyretic properties). They are administered by mouth, topically, rectally or by injection. They can be sold by prescription or over-the-counter. As a precaution and by regulation, some over-the-counter analgesics are placed behind the pharmacy counter, so the pharmacist can record their use in the patient's pharmacologic record.

The following medications are included in the class of analgesics:

  • acetaminophen
  • aspirin
  • nonsteroidal anti-inflammatory drugs or NSAID (ibuprofen, naproxen, diclofenac, celecoxib, etc.)
  • opioids (codeine, morphine, hydromorphone, oxycodone, fentanyl, methadone, tramadol, etc.)

Risk of adverse effects

As with all medications, analgesics can cause adverse effects even if they are taken as directed. Their safety profile differs from one agent to another. Acetaminophen is the safest analgesic when it is used with the recommended dosage; however, its use is not without risk. Aspirin is not used as much as it once was for pain, as its safety profile makes it less attractive than other available products.

Analgesics often have a rather constant adverse effects profile. In the case of NSAIDs, adverse effects mainly consist of digestive issues, such as sore stomach, acid reflux, nausea, and constipation. As for opioid analgesics, they can cause dizziness, drowsiness, nausea, and constipation. That being said, each individual reacts differently and a number of adverse effects are possible. Note that it is possible to be allergic to an analgesic.

Your pharmacist can inform you about the main adverse effects associated with analgesics. If you think you are experiencing one, contact your pharmacist promptly and he/she will tell you what to do.

Risk of drug interactions

When it is necessary to combine several medications, there may be a risk of drug interactions. This can be without consequence; however, a drug interaction can cause, for instance:

  • increased risk of adverse effects or drug toxicity
  • a reaction to a medication that is different than was expected
  • decreased effectiveness of one of the medications

Analgesics can be subject to a drug interaction or they can be the cause of it. For instance, a person taking warfarin (an anticoagulant) could see the effect of the medication significantly increased due to concomitant use of acetaminophen or of an NSAID. There is a risk of toxicity in this type of interaction.

When taking an analgesic, it is imperative to inquire about the risk of drug interactions from your pharmacist. Make sure to always have a thorough updated list of your medications, including over-the-counter medications and natural health products.

Risk of overdose or intoxication

Analgesics are considered to be safe and beneficial when the recommended dosage is followed—which is crucial. Some people can sometimes take a dose that is too high or in excessive quantity for various reasons, including a lack of knowledge or carelessness. An overdose of analgesics can have different consequences, sometimes serious ones, depending on the medication involved.

Let us take acetaminophen for example. When used properly, this analgesic is safe and effective. However, in too high doses, it can cause significant damage to the liver and even cause death. A great number of drug intoxication-related cases are reported each year in Canada. That is why public health authorities have recently issued recommendations concerning the use of this medication. Therefore, make sure to never go over the daily maximum recommended dose.

People who are more vulnerable, such as children, adolescents, and the elderly, are particularly at risk of overdose or intoxication. Remember that medications must always be stored out of sight and out of reach of children and of anyone who is considered to be at higher risk.

Risk of misuse, overuse, and addiction

Some people sometimes turn to medication to obtain effects other than for therapeutic purposes. Sensation-seeking such as euphoria (or getting high) or relaxation can lead them to make irrational use of certain medications, including analgesics. Although this phenomenon can be observed in people of all ages, an increase of these incidents has been noted in adolescents in particular.

It would not be expected that overconsumption of acetaminophen or NSAIDs, for instance, would have a particular effect other than to relieve pain. However, some preparations, such as those containing opioids, attract people who wish to use medications "recreationally." It goes without saying that this type of practice can have extremely serious consequences on health and on many other levels.

Thus, opioid analgesics are particularly likely to create an addiction when they are overused or used over a long period of time. Once addiction has set in, some individuals find it very difficult to stop taking them. This is why it is important to be well-informed in advance about the risks of addiction for all medications. It should be noted that, several analgesics, such as acetaminophen and NSAIDs, do not really have any risks of addiction. Your pharmacist can offer additional information on the matter.

Other contraindications, warnings, and precautions

There are certain contraindications, warnings, and specific precautions for each analgesic available on the market that are not addressed in detail in this text. Depending on your age, health status (diabetes, heart disease, high blood pressure, etc.) and your personal characteristics (pregnancy, breastfeeding, job, individual or family history, allergy or intolerance prior to taking medication, etc.), a particular analgesic may not be suitable for you.

As medication specialists, pharmacists can help you determine if you should refrain from taking certain analgesics. They can also help you choose medication that is likely to give you relief without causing other health issues and advise you on how to use it optimally and safely.

Analgesics are often of valuable assistance in the case of pain. When the time comes to obtain useful, objective, and thorough information on the subject, you can rely on another ally—your pharmacist!


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Taking analgesics—a few precautions for safe use

Analgesics are among the most commonly consumed medications, all categories combined. Therefore, it can be easy to trivialize their use. Yet, as is the case for all medication, the use of analgesics must coincide with certain precautions.