General Pain Relief Medicines

Pain Relief Medicine: Painkillers, Tablets and Gels for Headaches, Back Pain and Muscle Aches

Most people reach for pain relief a few times a year, for a headache that will not shift, a bad back, period pain or toothache. The right painkiller depends on what is hurting and why. Paracetamol suits mild to moderate pain and fever, ibuprofen helps when there is swelling or inflammation, and a gel treats one sore joint or muscle without the whole-body effects of a tablet. This range covers over the counter painkiller tablets such as Panadol, Cuprofen, Nurofen, Nuromol and Anadin, pain relief gels and creams such as Voltarol, Fenbid and ibuprofen gel, plus simple advice on choosing between them. Some of these are pharmacy medicines, so a pharmacist may check your order before it is supplied.

Types of Pain Relief Medicine

Over the counter painkillers fall into a few groups, and the active ingredient matters more than the brand name:

• Paracetamol: Panadol Advance has 500mg per tablet and suits headaches, period pain, toothache and general aches. SolpaOne is a 1000mg effervescent tablet for adults and teenagers from 16. Paracetamol does not reduce inflammation.
• Ibuprofen tablets and capsules: Cuprofen Maximum Strength has 400mg per tablet, while Nurofen Express liquid capsules have 200mg. Both are anti-inflammatory painkillers.
• Combination painkillers: Nuromol combines ibuprofen and paracetamol in one tablet, Anadin Extra combines aspirin, paracetamol and caffeine, and Alka-Seltzer Original pairs aspirin with an antacid in a fizzy tablet.
• Pain relief gels and creams: Voltarol Max Strength contains diclofenac, Fenbid and ibuprofen gel contain ibuprofen, Algesal contains diethylamine salicylate, and Biofreeze is a cooling menthol gel.
• For children: Nurofen for Children is an ibuprofen liquid for ages 3 months to 9 years.
• Toothache and headache extras: Orajel is a numbing gel for toothache until you can see a dentist, and the 4head stick is applied to the forehead for headaches.

Strongest Over the Counter Painkillers in the UK

People often search for the strongest painkiller they can buy without a prescription. There is no official ranking, because strength depends on the ingredient and the dose, not the brand, and a stronger tablet is not always the better one for your pain. In the UK the options run roughly like this:

• Ibuprofen and paracetamol together: Nuromol contains 200mg of ibuprofen and 500mg of paracetamol, is for adults over 18, and the leaflet limits it to six tablets in 24 hours for no more than three days. It should only be used if either ingredient alone has not worked.
• High-dose single ingredients: 400mg ibuprofen tablets such as Cuprofen Maximum Strength, or 1000mg paracetamol effervescent tablets.
• Codeine combinations: co-codamol 8/500 is generally the strongest pain relief sold over the counter, and it is a pharmacy medicine supplied by a pharmacist. It is only for short-term moderate pain that other painkillers have not eased, for no more than three days, never for under 12s or while breastfeeding, and it can cause dependence.
• Naproxen: over the counter naproxen is limited to 250mg period pain tablets for women aged 15 to 50, used for up to three days in each cycle. Naproxen 500mg tablets need a prescription.

For pain that is bad enough to make you want something stronger, see a GP rather than taking more than the pack allows.

How Painkillers Work: Paracetamol, Ibuprofen or Aspirin?

Paracetamol is the usual starting point. It is thought to work on how the brain processes pain, suits most adults, has few interactions, and works for mild to moderate pain and fever. The maximum is 8 tablets of 500mg in 24 hours, with at least four hours between doses, and the NHS paracetamol guidance is worth reading because too much can seriously damage the liver.

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). It blocks the chemicals that cause pain and swelling, so it is often the better fit for sprains, muscle strains, period pain and dental pain, where inflammation is part of the problem. The over the counter limit is 1,200mg in 24 hours, which is three 400mg tablets or six 200mg capsules. Check the NHS ibuprofen guidance if you have asthma, stomach ulcers or kidney problems. Aspirin works in a similar way, but it should not be given to anyone under 16.

Most tablets start to ease pain within 30 to 60 minutes, while fizzy and liquid forms can act a little faster. The active ingredient and daily limit stay the same, so check the strength on the pack rather than the brand when you compare.

Pain Relief Gels, Creams and Voltarol

For one sore area, a gel or cream is often enough. Ibuprofen gel and Fenbid contain ibuprofen, while Voltarol contains diclofenac, a different NSAID, so they are not the same product. Algesal and Movelat work in other ways again, so the labels are worth comparing. Topical products put far less of the drug into the rest of the body than tablets, but they are not risk free if you have a skin condition or an NSAID allergy. Wash your hands after applying, and keep gels away from broken skin, eyes and the mouth.

Which Pain Relief for Which Pain?

• Headache: paracetamol or ibuprofen tablets, and our headache relief range has more.
• Back pain and muscle pain: ibuprofen tablets or a gel such as Voltarol tend to suit better than paracetamol alone, plus our muscle and joint pain relief products. Flarin soft capsules also contain ibuprofen.
• Period pain: ibuprofen based tablets such as Feminax Express often suit better than paracetamol.
• Toothache: paracetamol or ibuprofen for a short time, with a dentist visit as the real fix.
• Nerve pain: shooting, burning or tingling pain usually does not respond to ordinary painkillers, so speak to a pharmacist or GP.
• Fever and aches in children: use the children's liquid dosed by age and weight.

Safety Points Worth Knowing

• Never combine two products with the same active ingredient, since paracetamol hides in many cold, flu and combination remedies.
• Take ibuprofen with or after food, and stop it and speak to a pharmacist if you get stomach pain or black stools.
• Adults should see a doctor if ibuprofen is needed for more than 10 days, or codeine for more than 3 days.
• Taking painkillers on more than 10 to 15 days a month can cause medication overuse headache.
• Always read the leaflet, and do not exceed the dose on the pack.

Pain Relief in Pregnancy

Paracetamol at the lowest effective dose is usually the first choice in pregnancy. Ibuprofen should not be taken in the last three months, and is only used earlier if clearly needed. Codeine is not recommended in the last trimester. Ask a pharmacist, midwife or GP before taking anything, and see our pregnancy products for more support.

Simple Habits Alongside Painkillers

Tablets work best as part of a plan. For a sprain, use rest, an ice pack wrapped in a cloth, compression and elevation for the first few days. For back pain, gentle movement usually beats bed rest. A hot water bottle helps period pain, and tension headaches often ease with water and breaks from screens.

When to Speak to a Pharmacist or GP

Speak to a pharmacist if you are unsure which painkiller suits you or you take other medicines. See a GP if pain is severe, keeps coming back or lasts more than a few weeks, or if you need painkillers most days. Get urgent help for a sudden, severe headache unlike any before, pain after a significant injury, or a headache with a stiff neck, fever or confusion. Call 999 for chest pain that spreads to the arm or jaw, or comes with breathlessness.

Frequently Asked Questions

1. What is the best pain relief tablet?

It depends on the pain. Paracetamol suits mild to moderate pain and fever, while ibuprofen is often better when there is swelling or inflammation. If you are unsure, a pharmacist can help you pick a safe option.

2. What is the strongest over the counter painkiller in the UK?

Codeine combinations such as co-codamol 8/500 are generally the strongest, and a pharmacist supplies them for up to three days. Among products anyone can buy, ibuprofen and paracetamol combined, such as Nuromol, is generally the strongest option, again for three days at most.

3. Is co-codamol stronger than ibuprofen?

Co-codamol is usually considered the stronger painkiller, but it is not better for every pain. Ibuprofen also reduces inflammation, so it often works better for sprains, back pain and period pain, without the dependence risk that comes with codeine.

4. Can you buy naproxen 500mg over the counter?

No. Naproxen 500mg tablets need a prescription. The only naproxen sold over the counter is a 250mg tablet for period pain in women aged 15 to 50. If naproxen is what you want, ask a GP.

5. Is it better to take paracetamol or ibuprofen?

Neither is better for everyone. Paracetamol is gentler on the stomach and has fewer interactions, while ibuprofen also reduces inflammation. If you have asthma, a stomach ulcer or kidney problems, paracetamol is usually the safer first choice.

6. Can I take paracetamol and ibuprofen together?

Yes, they work differently and can be taken together or alternated, as long as you stay within the daily limit for each. A pharmacist can talk you through a safe schedule.

7. Are pain relief gels as good as tablets?

For a single sore joint or muscle, a gel can work well with far less of the drug reaching the rest of your body. For widespread pain, headaches or period pain, tablets usually work better.

8. Is Voltarol the same as ibuprofen gel?

No. Voltarol contains diclofenac, while ibuprofen gel and Fenbid contain ibuprofen. Both are topical NSAIDs, and you should not use two similar gels on the same area at once.

9. How long do painkillers take to work?

Most painkiller tablets start working in 30 to 60 minutes. Soluble and liquid forms can be a little quicker, and gels take longer to build up at the sore spot. If a dose has not helped after an hour, do not take extra. Check the pack for when you can safely take the next dose.

10. What is the best painkiller for back pain or muscle pain?

Ibuprofen tablets are often a better fit than paracetamol alone because they reduce inflammation, and a gel such as Voltarol can target one sore area. Keep moving gently, and see a GP if the pain is severe or lasts more than a few weeks.

11. Can I take painkillers while pregnant?

Paracetamol at the lowest effective dose is usually the first choice. Ibuprofen should not be taken in the last three months of pregnancy. Always check with a pharmacist, midwife or GP first.

12. What pain relief can children have?

Children's paracetamol and ibuprofen liquids are dosed by age and weight, so use the measure supplied. Aspirin should not be given to anyone under 16, and codeine is not for under 12s.

13. What is the best pain relief for period pain?

Ibuprofen based tablets such as Feminax Express often work better than paracetamol, because period pain involves inflammation. Take them with food, avoid them if ibuprofen does not suit you, and see a GP if the pain is severe or getting worse.

14. What can I take for toothache until I see a dentist?

Paracetamol or ibuprofen can ease toothache for a short time, and a numbing gel such as Orajel gives temporary relief on the spot. None of these treats the cause, so book a dentist, and get urgent help if you have swelling in your face or neck or a fever.

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