What you need to know about pain relievers

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In any drug store, there’s an aisle dedicated to a variety of brands, sizes and forms of pain relievers. Liquids, gels and tablets can all be used to treat headaches, muscle soreness or any other ache and pain, but the difference between pain relievers might not be clear.

Depending on the symptoms you’re experiencing, one type of pain reliever might be more efficient than another.

What’s the difference between pain relievers?

There’s a variety of pain relievers that can be found, both over-the-counter and prescription-only. Different classes of drugs work on different targets within the body. These classes included opioids (Percocet, oxycodone, hydrocodone, dilaudid, etc.), TCAs (amitriptyline, nortriptyline), SNRIs (duloxetine, venlafaxine), NSAIDS (ibuprofen, meloxicam), muscle relaxants (tizanidine) and gabapentinoids (gabapentin, pregabalin). A lot of these medications are chosen based on side effect profile and individual differences among patients.

When should each type of pain reliever be used?

Each type of pain reliever has different indications, risks, benefits and side effects. If a patient is experiencing chronic pain, multiple combinations of these medications are used as treatment. The thought behind this is that we can target multiple receptors and pain pathways while using a smaller, better-tolerated dose with each of the individual medications.

Are generic brands still effective?

Yes. In fact, most of the medications we use for chronic pain have been off brand and are just as effective as their more expensive brand formulations.

When should you stop using over-the-counter pain relievers and consult a physician?

When pain leads to significant interference with daily activities, you should consult a physician. You should never abruptly stop a prescription pain reliever without first consulting a physician, as many of these medications may lead to withdrawal symptoms.

Is there anything to be cautious about when choosing a type of pain reliever or switching types?

Absolutely. There are many pros and cons taken into consideration when choosing a pain reliever or switching between classes of pain relievers. These considerations are patient-specific and, therefore, it’s very important to let your physician know if you decide to switch, stop or increase your current medications.

Tristan Weaver is an anesthesiologist at The Ohio State University Wexner Medical Center.

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