Common Over The Counter Pain Relievers

Acetaminophen More Commonly Referred To As Paracetamol

When it comes to pain relievers, Paracetamol (also known as acetaminophen) is often the first choice. It’s widely used as both a pain reliever and fever reducer. Paracetamol is commonly used to treat non-inflammatory musculoskeletal conditions, such as:

• Headache
• Muscle aches
• Arthritis (helps with pain from mild arthritis, but doesn’t address joint inflammation)
• Backache

Common brand names for paracetamol include Panadol and Panamax. It’s considered effective for relieving mild to moderate pain.

Note: While acetaminophen generally has few side effects, taking more than the recommended dose can lead to serious liver damage.

For stronger pain, paracetamol is sometimes combined with other medications. These combination drugs are usually prescription-only due to increased risks, such as side effects or dependency.

Over-The-Counter Pain Relievers Containing Multiple Active Ingredients

Panadeine

Panadeine is an over-the-counter medication containing two active ingredients: paracetamol and codeine. These work in different ways. Codeine is an opioid analgesic. It attaches to opioid receptors in the nervous system, which then block pain signals being sent to the brain.

While opioids are powerful pain relievers, they also come with risks. Side effects and the potential for dependency mean that stronger doses are prescription-only and must be used under medical supervision.

Note: The Society of Hospital Pharmacists of Australia does not recommend codeine in doses below 30mg, as such low levels are unlikely to offer effective relief. Over-the-counter Panadeine contains only 8mg of codeine phosphate per tablet — meaning the standard two-tablet dose delivers just 16mg, which is considered too low to be effective by the Society.

Common Side Effects of Panadeine

Codeine phosphate may cause several side effects, including:

• Dry mouth
• Dizziness
• Nausea and vomiting
• Constipation (especially with prolonged use)

Mersyndol

Mersyndol is another over-the-counter medication with multiple active ingredients. It contains paracetamol, codeine phosphate hemihydrate, and doxylamine succinate. It’s commonly used to manage non-inflammatory conditions like tension headaches and migraines.

Like Panadeine, Mersyndol combines paracetamol and codeine for pain relief. In addition, it includes doxylamine — an antihistamine that provides a sedative or calming effect.

As of February 2018, pain relief medicines containing codeine require a prescription. This regulation change affects products such as Panadeine, Mersyndol, and Nurofen Plus.

Please Note: Sydney physiotherapists cannot prescribe pain relief or anti-inflammatory medications.

Disclaimer: Sydney Physio Clinic provides this content for educational purposes only. It is not intended as medical advice. For specific recommendations about over-the-counter pain relievers, please consult your GP, pharmacist, sports medicine doctor, orthopaedic specialist, or another qualified healthcare provider.