Many pain medicines are very effective when used correctly, but they carry important risks if used in the wrong dose, for too long, or alongside other medicines. This page summarises what UK regulators and clinicians want patients to know.
Paracetamol
- Adult dose: 500 mg–1 g, up to four times a day. Maximum 4 g (8 standard tablets) in 24 hours.
- Check other medicines (e.g. cold and flu remedies, co-codamol) — many also contain paracetamol.
- Overdose can cause serious liver damage, even if you feel well at first. If you take more than the maximum dose, seek urgent medical advice immediately.
NSAIDs (ibuprofen, naproxen)
- Take with or after food to reduce stomach irritation.
- Use the lowest dose for the shortest time.
- Avoid or use with caution if you have stomach ulcers, kidney problems, heart failure, asthma triggered by NSAIDs, or are pregnant (especially after 20 weeks).
- Long-term NSAID use can increase the risk of stomach bleeding, heart attack and stroke. Stomach protection (e.g. a PPI) may be recommended.
Codeine, dihydrocodeine and other opioids
Opioids can be helpful for some types of acute pain but are not recommended by NICE for chronic primary pain and carry a real risk of dependence, especially with daily use beyond a few weeks.
- Use only as prescribed, at the lowest effective dose, for the shortest time.
- Do not combine with alcohol or other sedatives.
- Tolerance and dependence can develop. If you've been taking opioids regularly for more than a few weeks, do not stop suddenly — speak to your GP or our pharmacist about a safe taper.
- The MHRA requires warnings about addiction on the packs of all opioid-containing medicines.
Codeine in over-the-counter combinations
Products combining codeine with paracetamol or ibuprofen (e.g. some Solpadeine and Nurofen Plus products) are licensed for short-term use only — maximum 3 days. If pain continues beyond that, see your GP or speak to our pharmacy team.
Medication-overuse headache
Taking pain relief (including paracetamol, NSAIDs, codeine and triptans) on more than 10–15 days a month can paradoxically cause more frequent headaches. If this sounds familiar, please speak to us — pulling back gradually usually helps.
Reporting side effects
Suspected adverse reactions can be reported via the MHRA Yellow Card scheme. Reporting helps make medicines safer for everyone.
If you are worried about your pain medicine
You can book a confidential medication review with our pharmacy team via the Pain Clinic. There is never any judgement — many people benefit from a structured review, and tapering can be done safely with support.