Simple analgesics (non-opioid analgesics)

What are simple analgesics?
What are simple analgesics used for?
How do the simple analgesics work?
Precautions
Side effects of simple analgesics

What are simple analgesics?

Simple or non-opioid analgesics are a diverse group of drugs that include anti-inflammatory drugs (non-steroidal anti-inflammatory drugs or NSAIDs) and paracetamol.

Most anti-inflammatory drugs also have the ability to relieve fever and antiplatelet (anti-clotting) properties. Paracetamol has the ability to reduce fever, but has minimal anti-inflammatory effects and no effect on blood clotting. Paracetamol is the preferred option for fever and mild-to-moderate pain as it has fewer adverse effects.

What are simple analgesics used for?

NSAIDs, including aspirin, are indicated for:

Fever
Mild-to-moderate pain due to inflammation and tissue injury
Migraine and tension headache
Period pain
Pain caused by bone cancer
Rheumatoid arthritis, including juvenile rheumatoid arthritis
Osteoarthritis
Rheumatic fever
Pain caused by an attack of gout (not aspirin)

Paracetamol is indicated for:

Mild-to-moderate pain
Fever
Migraine and tension headache

How do the simple analgesics work?

Anti-inflammatories relieve pain and inflammation within the body by decreasing the production of pro-inflammatory chemicals known as prostaglandins. Prostaglandins are normally produced in response to tissue damage, and are known to play a major role in the processes of inflammation, pain and fever.

Paracetamol also works by reducing the synthesis of prostaglandins.

Precautions

Asthmatics:

In some asthmatics anti-inflammatory medicines can trigger an asthma attack.
If you suffer from asthma you should consult your doctor before taking any non-steroidal anti-inflammatory medication.

Crohn’s disease:

Crohn's disease can be exacerbated by anti-inflammatory medication.
If you suffer from Crohn's disease you should consult your doctor before taking any non-steroidal anti-inflammatory medication.

History of peptic ulcer disease (stomach ulcers):

Anti-inflammatory medication can increase the risk of further ulceration or bleeding.
If you have a history of peptic ulcer disease you should consult your doctor before taking any non-steroidal anti-inflammatory medication.

Heart Failure and High Blood Pressure:

Heart failure and high blood pressure may be exacerbated with the use of anti-inflammatories.
If you suffer from heart disease or high blood pressure you should consult your doctor before taking any non-steroidal anti-inflammatory medication.

Pregnancy:

Non-steroidal anti-inflammatories are ADEC pregnancy category C.
Before taking anti-inflammatory medication pregnant women, should discuss the benefits and risks with their doctor.

Breastfeeding:

For the effects of Statins on breastfeeding, consult your healthcare professional.

Children

Children under 18 years should not use aspirin as there is a risk of Reye’s syndrome.

Paracetamol

Pregnancy and breastfeeding:

Safe to use
ADEC category A

Side effects of simple analgesics

NSAIDS: Most common side effects are mild. Listed below are the common (≥1%) and infrequent (<1%) side effects of non-steroidal anti-inflammatory medications (NSAIDS). You may not experience any side effects.

Common:

Nausea, dyspepsia
Ulceration or bleeding of the stomach or intestines
Diarrhoea
Headache
Dizziness
Salt and fluid retention(oedema)
High blood pressure

Uncommon:

Ulceration of the oesophagus
Rectal irritation (with suppositories)
Heart failure
Confusion
Asthma attacks
Rash

Speak to your doctor if you experience or are concerned about any of these or other side effects.

Paracetamol: Reports of side effects are rare at recommended doses. The following side effects have been reported:

Dyspepsia
Allergic reactions and blood disorders

Speak to your doctor if you have any concerns regarding the use of paracetamol.

Reference

Australian Medicines Handbook. Non-opioid analgesics[online]AMH Pty Ltd 2007[cited Feb 8, 2008] http://www.amh.net.au
MIMs Online. [online]MIMS Australia Pty Ltd 2007.[Cited Feb 8, 2008] http://www.mims/com.au