NHS Dudley Health Economy Medicines Formulary
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4.7 Analgesics

Click here to see Dudley Guidelines for the Drug Treatment of Pain in Primary Care

General guidance

  • Paracetamol and aspirin are particularly suitable for pain in musculoskeletal conditions, whereas the opioid analgesics are more suitable for moderate to severe visceral pain.
  • Remember as analgesia potency increases so does the frequency and severity of adverse effects.
  • If patients report the unsuccessful use of over-the-counter analgesics always enquire about the frequency of administration. Consider the use of regular full doses of these analgesics before use of another agent.
  • Consider the availability of analgesics over-the-counter.
  • Only prescribe effervescent preparations when there is a real need – these products contain substantial amounts of sodium and are expensive.
  • Consider the edition of a NSAID (see section 10.1.1) if an inflammatory component is suspected.
  • In general, when assessing pain, it is necessary to weigh up carefully whether there is a need for a non-opioid and an opioid analgesic to be taken simultaneously.
  • For advice on terminal care see local guidelines or BNF section. Alternately consider referral to McMillan or hospice teams or other local specialists.
  • Paracetamol and aspirin are particularly suitable for pain in musculoskeletal conditions, whereas the opioid analgesics are more suitable for moderate to severe visceral pain.
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