Painkillers: with so many painkillers on the market these days, choosing one is enough to give anyone a headache. Here's some help with the choice. (Health: painkillers).(Cover Story)

Publication: Choice (Chippendale, Australia)

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COPYRIGHT 2002 Australian Consumers' Association

There are well over 100 over-the-counter (OTC) painkillers available, and it helps to know what the different active ingredients do, who should and shouldn't take them, and what conditions they're suitable for.

This article covers general-purpose painkillers (also called analgesics) for common types of pain, such as headache, toothache, fever, sprains and strains, arthritis and period pain. It also takes a brief look at children's products (page 16).

OTC painkillers fall into three main classes: nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin; paracetamol; and opioids or narcotics, which include codeine. The types differ in the way they work and their side effects, and for this reason not all drugs will suit all people -- particularly if you're very young or an older person or have any of various health complaints.

CAN'T TELL YOUR CAPLETS FROM YOUR TABSULES?

That's not surprising really, because there's no difference: both are capsule-shaped tablets. The idea is that they're easier to swallow than ordinary round tablets, but smaller than powder-filled capsules. Easier again are `capseals' and `gel caps', which have a solid core of analgesic with a gelatin coating, so they're much like caplets with a slippery coating. Also available are `gel tabs' -- gel-coated round tablets.

These innovations (along with soluble or dispersible tablets) may make painkillers easier to swallow, but in most cases you'll pay more.

ARE PREMIUM BRANDS BETTER THAN NO-NAMES?

If you're buying paracetamol, no-name products have the same amount of active ingredient and work just as well as the big-name brands -- so forget brand loyalty and buy on price. The same applies to aspirin.

When we last reported on painkillers (February 1997), no-name supermarket products were a very small segment of the market, with only 3.9% market share. With consumers now more aware that no-name products are essentially the same as branded products, the figure for 2000 was about 19% -- a massive increase.

WHAT SHOULD I BUY?

Despite the range of products on the market, choosing a painkiller is quite simple:

* Decide which of the active ingredient/s you'd like, according to the kind of pain it is, your age and general state of health (see pages 13 to 15 for what's available).

* Go for ordinary tablets, unless you have difficulty swallowing them, because they're usually cheaper. See Can't tell your caplets from your tabsules?, above.

* Finally, choose the cheapest brand you can find, which for paracetamol and aspirin is likely to be no-name brands from supermarkets, where you can buy small packs (under 25 tablets).

You'll need to go to a pharmacy for larger packs of aspirin and paracetamol, for products containing codeine, children's products and NSAIDs other than aspirin. They're scheduled S2 -- Pharmacy medicine. In remote country towns where it's difficult to get to a pharmacy, S2 products may be sold in grocery stores that hold a poisons licence.

Products that contain three active ingredients (such as a...

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