Ask a pharmacist - why?
This week is Ask Your Pharmacist Week. If you're reading this blog, you almost certainly take an interest in your own health. We're all encouraged to take control of our own health these days, and long gone are the days where the only source of health information was the doctor. But it's not just the internet (always assuming it's a reputable site like patient.info!) which can answer your health queries. These days, pharmacists are highly trained to deal not just with prescriptions but with a host of health conditions which used to be the exclusive domain of the doctor - they can advise on medications available without prescription, whether you need to seek medical help and how you can make the most of medications you take.
A new campaign in pharmacies aims to help more people take advantage of the NHS Medicines Use Review service. Anybody who takes medicine for a long-term condition, or takes more than one medication regularly, is entitled to an annual medication review from their pharmacist. This can complement the advice you get from your doctor and allow you to bring up all those queries you meant to raise at your last GP appointment. The pharmacist can advise on interactions between medications (including those not on prescriptions), side effects and timings of medicines. They may make it easier for you to stick with medications you've been prescribed and ensure you get the maximum benefit from it. What's more, it's free!
This year's campaign is focusing specially on men - we know they see their GP less often than women do, yet they have just as many long-term conditions and their risk of certain diseases like heart disease is even higher than their female counterparts. Your pharmacist can often offer a heart health check including blood pressure and cholesterol measurements.
Painkillers - pharmacy, prescription and when are they safe?
All of us get pain at some time. Lots of my patients worry that taking painkillers for pain will stop them from working in the future. This is very rarely true - taking painkillers for pain is not a sign of weakness, but a natural wish to get on with your life!
As long as you stick to the guidelines below, painkillers without prescription are usually fine for short-term pain (like sprains, muscle and joint aches, toothache and headaches). If the pain persists for more than a few days, or isn't helped by the painkillers, you should see your doctor. As far as headaches are concerned, painkillers can become the problem rather than the solution. The latest guidance by NICE reminds us that taking painkillers too often can result in 'medication-overuse headaches' which can be very debilitating.
For longer-term pain, your doctor may well be able to prescribe painkillers, making them cheaper than over-the-counter versions. If your pain changes or gets worse, you should go back to your doctor.
Painkillers - what's what?
There are two main types of painkiller available without prescription. Oral painkillers (in tablet, capsule or liquid form) include:
- codeine products
Aspirin, paracetamol and ibuprofen all help to relieve fever, as well as helping with pain. Ibuprofen can also help to relieve inflammation and swelling - so it may be especially good for sprains and strains.
Obviously, these medications should never be taken in higher doses than those recommended on the packet. Paracetamol is usually safe for everyone (in doses up to 1 g (two standard 500 mg tablets) every six hours) and has very few side effects. Ibuprofen and aspirin can cause inflammation of the stomach - symptoms include nausea, upper stomach pain and bleeding from the stomach. Some people should avoid them (see below) and you should always stop them immediately if you get any of these symptoms. Codeine is only available in combination with other painkillers. It works together with these painkillers to make them more effective.
Topical painkillers are painkillers in gel, cream, linament, ointment or spray form. They are often safe if you cannot take oral painkillers (although if you've been told to avoid oral painkillers, you should always check with your pharmacist or doctor before using topical preparations). Topical painkillers work on the area you apply them to. They often help to relieve inflammation as well as pain. They are particularly useful for sprains, strains, mild arthritis pain and rheumatism.
What's the difference between painkillers on presciption and painkillers from the pharmacist?
Nearly 30 years ago, the first 'POM-P' switch - changing a medicine from Prescription-only Medicine (POM) to making it available from your pharmacist with his or her advice and cautions (P) - was a painkiller, ibuprofen. Today, hundreds of medicines including oral and topical painkillers can be bought without prescription, and sometimes even without supervision from a pharmacist. These tablets are just the same as the equivalent on prescription - just as effective, but also just as likely to cause side effects and complications as their prescribed counterparts. Always follow the instructions on the packet - recommended doses are there for a reason.
When should I watch out?
You should avoid taking pain medication without consulting a healthcare professional if:
- You are taking other prescribed medication (your pharmacist will usually be able to tell you if, and which, painkillers are safe)
- You have kidney or liver disease
- You have asthma (some painkillers, like ibuprofen and aspirin, can occasionally make asthma worse)
- You have had a stomach ulcer
- You have indigestion (painkillers like paracetamol are usually fine, but ibuprofen and aspirin can make matters worse)
- You have colitis (inflammation of the colon)
- You have a bleeding or clotting disorder of the blood.