Analgesics

What are analgesics?

Analgesics are medications that relieve pain. Unlike medications used for anesthesia during surgery, analgesics don’t turn off nerves, change the ability to sense your surroundings or alter consciousness. They are sometimes called painkillers or pain relievers.

What are analgesics used for?

Analgesics are used to relieve pain and inflammation. For example:

• After surgery.
• Due to injury, such as a fractured bone.
• For acute (sudden, short-term) pain, such as a twisted ankle or headache.
• For aches and pains like menstrual cramps or muscle soreness.
• For chronic painful conditions such as arthritis, cancer or back pain.

How do these painkillers work?

There are two major groups of analgesics: anti-inflammatory analgesics and opioids. Anti-inflammatory drugs work by reducing inflammation (swelling) at the site of the pain. Examples include:

• Acetaminophen.
• Aspirin.
• COX inhibitors.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen.

Analgesic opioids (also called narcotics) work by changing the brain’s perception of pain. An opioid can be any drug, natural or manmade. Many are similar to morphine, but newer, unrelated opioids have been created in the laboratory, too. Examples include:

• Codeine.
• Fentanyl.
• Hydrocodone.
• Meperidine.
• Methadone.
• Naloxone or naltrexone.
• Oxycodone.

Who prescribes analgesic pain medication?

Some pain medicines are available over the counter (OTC), which means you don’t need a prescription at all. Others are available by prescription only: often these include higher doses of OTC medications, combination analgesics and all opioids.

How should you take analgesics?

Pain relievers are available in many forms, including:

• Films you place under the tongue to dissolve.
• Liquid you inject into your body with a syringe (needle).
• Liquid you swallow.
• Nasal spray that goes up the nose.
• Patches you place on the skin.
• Pills, tablets or capsules you swallow.
• Powder you mix and take various ways.

Ask your healthcare provider what route is best for you. Your healthcare team can also help you determine the right dose to take, how often and for how long.

What are the risks of using pain relievers?

Anti-inflammatory analgesics are generally safe. But they can cause side effects and complications, if you use them too often, for too long or in very large doses:

• Damage to internal organs, such as the liver or kidneys.
• Diarrhea or constipation.
• Heart problems.
• Hypersensitivity response, which is like an allergic reaction.
• Nausea, upset stomach or heartburn.
• Ringing in the ears, or even deafness.
• Stomach ulcers.
• Trouble forming clots in the blood, which can lead to excessive bleeding.

Opioid analgesics can cause many of the same side effects and complications. Opioids are tightly controlled because they can cause physical dependence and are prone to abuse. The problem, which doctors now call substance abuse disorder, can be mild, moderate or severe, so it isn’t always recognized right away.

Some tell-tale signs a problem may be developing include:

• Often taking the medication in larger amounts than were intended.
• Unsuccessful efforts to cut down.
• Repeating failure to fulfill major obligations at work, school or home.
• Continued use despite having persistent problems.
• Giving up important social activities.
• Using even in dangerous situations (driving).
• Tolerance.
• Withdrawal.

Make sure you keep all pain relievers out of children’s reach.

Does pain medication stop working after a while?

Over time, you may find that an analgesic can become less and less effective, which is called tolerance. You may need higher doses or more frequent doses, but you should be careful to avoid side effects and dependence.

Does insurance cover painkillers?

Check with your health insurer. Many prescription analgesics are covered, but most over-the counter analgesics are not.

When should I get medical attention for painkiller side effects?

Seek prompt medical attention if you are on a pain medication and experience:

• Allergic reactions like a rash or swelling anywhere on the body.
• Black bowel movements (also called poop or stools).
• Blood or something that looks like coffee grounds in vomit.
• Changes in vision or hearing.
• Severe stomach pain or headache.
• Trouble urinating, or pee that is cloudy or discolored.
• Yellowish skin or eyes (jaundice).
• Unusual weight gain.

A note from Cleveland Clinic

Analgesics are medications that treat your pain by reducing inflammation or changing the way your brain understands pain. Many types of analgesics are available, and they range from pills and liquids, to gels and patches you apply to your body. Some are available over the counter, and some require a prescription from your healthcare provider. Your provider can help you figure out the type of medication that's most effective for your type of pain.