It sounds like some truly awful wrestling pay per view event: This time, it’s personal! In reality, it is one of the questions that I get asked all of the time in my work as a pharmacist, and it is deeply frustrating for one simple reason: They are both the same. Both of them are derivatives of paracetamol, so pitting them against each other is like saying “Should I go to the far NSW North Coast, or Byron Bay?” or “Do we want pizza or Italian for dinner tonight?” Panamax vs Panadol? You can’t go too wrong here.
Stay with me here. Everything that you see on the shelves in a chemist is a brand name. Nurofen, Panadol, Difflam, Betadine… you name it! Each of these brands uses a variety of different drugs to create their product, and so there is an art to knowing something about the drugs that sit behind these brand names. Today, I am going to traipse through the world of pain medication in the hopes that you might be able to make better choices, and never again will you ask anything about Panamax vs Panadol…
This is a drug which has been rigorously tested for the better part of fifty years, and scientists still aren’t sure why it works. But it does! Essentially, it takes about 30 minutes after ingestion to begin working, and it heads to your brain and begins to dull the pain receptors in your brain which are registering the hurt. It doesn’t do anything to reduce the inflammation which is causing your pain, but you just stop feeling it so badly after a while. At the end of the day, isn’t that really what you’re after? Relief from the pain? It usually lasts for about six hours, so it puts in a serious shift. Because it isn’t going to the inflamed part of the body, it can actually be used in conjunction with many other pain relief medications. They don’t interfere because never the twain shall meet. You just need to be careful you’re not taking another product which blends both paracetamol and Ibuprofen. Overdosing on paracetamol can do bad things to your liver, so make sure you read the packaging. You will want to be on the lookout for products like Panadol, Panamax, Dymadon or the generic brand called ‘Paracetamol’ - The clue is in the name.
This is the pain relief which I often recommend pairing with paracetamol. Ibuprofen is an anti-inflammatory which goes to the site of inflammation and begins to reduce swelling and pain. It reduces your body’s capacity to produce something called prostaglandins - these are the chemicals that create pain, fever and cause the blood vessels to become inflamed. If you’ll forgive the clumsy metaphor, Ibuprofen is the child who desperately puts out the fire in the backyard, while paracetamol is the child who runs interference by keeping mum focused on the front yard. It’s a match made in heaven. You will want to be on the lookout for Nurofen, Advil, Pedea, or the generic brand simply called ‘Ibuprofen’.
Together, these two drugs work really well to counter mild to moderate pain, such as:
- Sinus pain
- Back ache
- Muscular pains (soft tissue damage)
- Period pain
- Sore throat
They are available in large quantities without a prescription so they are easy to come by.
Acetylsalicylic acid (also known as Aspirin - this is the brand name, but the actual drug is so poorly known that I’ve made an exception in this case).
Aspirin has actually been in use for over 4000 year. It was a compound discovered in myrtle and willow tree, and helped the Ancient Greeks recover from their mild to moderate illnesses. Consider what the Ancient Greeks got done! Aspirin must get the job done! It works by thinning the blood so that whatever inflamation you are experiencing, it becomes less severe and blood stops gathering at the point of pain. It is also excellent for your heart health for this very reason. If your blood isn’t clotting in your heart, it becomes very difficult to have a heart attack. Some people take aspirin daily to minimise their chances of a cardiac episode. Both Aspirin and Ibuprofen are non steroidal. They are also non narcotic, so they don’t alter your mental state or become addictive.
This is where things get a little bit more precarious. These include things like oxycodone, morphine, codeine, and many more. Have you ever heard the term ‘opioid epidemic’? This relates to a crisis (predominantly in American, but present in Australia nonetheless) where people become addicted to these powerful painkillers. During the 1990s, unethical pharmaceutical companies began pushing these drugs into the hands of consumers who just wanted relief from their pain. If I waved a box in front of you and said ‘you won’t even know you’ve just had surgery with a few of these’, you would be desperate. And perhaps rightly so. But imagine we begin offering that same level of potency for a run of the mill headache? That is what was beginning to happen, and because they were highly addictive, millions of people became dependent. That’s a win for these companies. The only problem is that overdosing is often lethal. It is essentially heroin. In the years from 1999 to the 2016, almost half a million Americans died in this manner. In Australia, you are 2.5 times more likely to die from a legal opioid than from heroin.
My point is this: be wary about using these drugs if you have been prescribed them. They are incredibly useful for a season, but opting on the side of caution is a good idea. This is especially the case because pain can be managed with less potent, less lethal drugs.
I realise that this took a pretty dark turn. My apologies. But I hope you feel empowered to make more education decisions about your pain relief medication. Used properly, these drugs are safe, effective and easy to source.
Floyd - Senior Pharmacist.