PAIN MEDICATIONS

PANADOL (Paracetamol, Panadol Osteo)

This is a simple pain reliever, which should be taken on a regular basis to reduce your need for stronger medications. Take 2 tablets 3-4 times per day. Panadeine forte has codeine added for extra pain relief but may cause drowsiness or nausea or constipation. Do not take more than 8 tablets of either medication in 24 hours.

ANTI-INFLAMMATORIES

These include MOBIC, CELEBREX, NAPROSYN and VOLTAREN. Take with a glass of milk or after a meal. If you have kidney disease, stomach ulcers, heart failure or previous allergic reactions you may need to avoid these tablets. Otherwise continue to take these every day during the first week after surgery then once daily only if needed in the second week then stop. Some patients may continue to take anti-inflammatories longer term after discussion with your doctor.

LYRICA (Pregabalin)

This is an important pain reliever which can reduce pain during your hospital stay and also reduce the risk of longer term pain after your surgery. It may cause dizziness and drowsiness or occasionally hallucinations in some individuals. At higher doses it may also cause blurred vision which is relieved by reducing the dose. Initial dose is typically 75mg twice daily or simply once daily at night.

STRONG PAIN TABLETS

PALEXIA (Tapentadol)

This is a newer pain killer for moderate to strong pain which can be very effective for pain. It comes as 50mg slow release (SR) available twice per day or 50mg immediate release (IR), which can be taken every 2-4 hours as needed. Initially you will receive regular PALEXIA SR and if you need additional pain relief then you will be offered the PALEXIA IR in addition. As you progress you may stop taking the PALEXIA SR if you no longer need it.

 

PALEXIA may have some side effects similar to morphine such as nausea, sedation & itch.

 

Most patients will be prescribed PALEXIA but if required there are some alternatives listed below.

 

Targin

This is an alternative to Palexia. It is also available twice daily as needed. It may cause more nausea than Palexia.

 

Endone (Oxycodone)

Comes as 5 or 10mg available every 2 hours in hospital then 4-6 hourly when at home. It is a strong pain killer with a quick onset but only lasts ~2hours. This is good to take before physiotherapy or when pain is not well controlled.

 

Temgesic

This tablet goes under the tongue and is similar to endone but slightly slower in onset and longer acting.

 

Norspan skin patch

This contains the same medication as Temgesic. Some patients will be offered a norspan patch, which is applied to the skin and lasts 1 week. The patch comes in 5 or 10 microgram strengths. This may also cause the same side effects as above.

 

Tramadol

Available as slow release (twice daily) or immediate release (x4 per day). This is for moderately strong pain and may suit some patients. However it is not well tolerated by all and sedation and nausea is not uncommon. Avoid if any history of seizures.

SIDE EFFECTS

 

All strong pain medications have the potential for side effects, which include nausea, vomiting, dizziness, confusion, itch, dry mouth, constipation and possibly hallucinations. If you are on strong pain relievers avoid alcohol, driving and operating machinery. Sedation may be improved by reducing the dose or taking the medication less often. If you feel excessively light-headed, spaced out or nauseated, try reducing your dose. If your symptoms persist try an alternative pain reliever or contact your doctor (see below). To prevent constipation, ensure you have adequate fluid intake and dietary fibre. You may also need to take regular laxative until you no longer need strong pain relievers. If you have a Norspan skin patch on and you have experienced persisting nausea or sedation the patch may have to be removed to alleviate the side effects and an alternative pain reliever used.

 

© MJLennon FANZCA

Affiliated with The Joint Studio

 Hollywood Medical Centre

Suite 1, 85 Monash Avenue

Nedlands

Western Australia 6009