types of painkiller
There are different ways of giving painkillers. You can have painkillers as:
- tablets
- a liquid
- injection
- infusion through a drip
- a patch on your skin
- suppositories (into your bottom)
If your pain isn’t too bad the doctor will probably give you a mild painkiller like paracetamol or an anti-inflammatory like ibuprofen (brufen). If that doesn’t help the doctors would try a slightly stronger painkiller like codeine. If you’re still in pain then they might try something stronger like morphine.
These are some commonly used painkillers:
- mild painkillers - paracetamol, aspirin, ibuprofen
- moderate painkillers - solpadol, dihydrocodeine, cocodamol, codydramol
- strong painkillers - morphine, diamorphine, fentanyl, hydromorphone, methadone, oxycodone
what about side effects?
Paracetamol doesn’t tend to have many side effects but aspirin and ibuprofen can irritate your stomach. It’s best not to take them on an empty stomach or with alcohol.
Stronger painkillers like codeine and morphine can make you feel sick and they can also make you constipated. Your doctor can give you anti sickness medicine and a laxative to help you go to the loo while you’re on them. They can make your mouth dry too. Drinking plenty of water or juice, or chewing gum, can help.
A lot of people are scared of taking morphine. You or your parents might worry you’ll get addicted to it or it will make you feel woozy and out of control. You can’t get addicted to painkillers when you’re taking them for cancer pain. Strong painkillers can sometimes make you feel a bit dizzy or sleepy at first but that usually settles down after a few days.
Your doctor will decide the right dose of painkillers for you. There’s no limit to how long you can be on them and if you take the dose they tell you to there’s no risk of overdose.
Strong painkillers, like morphine can be given in different ways. You can have an immediate release tablet or liquid which you can take when you need it (usually every 2–4 hours) or a ‘slow-release’ tablet that you take every 12 or 24 hours.
When you start on morphine you’re usually given the more short acting immediate release tablet. Once the doctors know how much you’re taking they can work out the best dose of the slow-release tablet for you. Once you have started the slow-release tablet you can still take an immediate release tablet if you’re still in pain.
If you have to take lots of doses of the immediate release tablet then your doctor may be able to increase the dose of your slow release tablet. This will control your pain better inbetween doses. You can have as much morphine as you need to control your pain.
Sometimes the doctors might give you a painkilling patch (fentanyl patch) instead which you stick to your skin, but these aren’t suitable for everyone. They slowly release the painkiller which is absorbed through your skin. They have to be changed every three days and stuck in a different place on your body.
anti-depressants and anti-epilepsy drugs
You may also be given drugs that are more commonly used for depression or epilepsy because doctors have found they can also help control pain. These drugs can be really good for nerve pain which can be caused by the tumour pressing on a nerve. They can take about a week to work though so it’s important to keep taking them even if you think they might not be working.
bisphosphonates
Bisphosphonates are a kind of bone-strengthening drug. They can be useful for pain caused by cancer in the bones. Bisphosphonates can be given as a drip into a vein once a month or as a tablet every day.
Steroids can help when pain is caused by inflammation, or the tumour is pressing on a nerve.
muscle relaxants
If muscle spasms are making pain worse, you might be given a drug to relax the muscles.
antibiotics
If the pain is caused by an infection you would usually be given antibiotics to treat the infection and painkillers to help with the pain until the infection goes away.
