A visit to the pharmacy for pain relief can be complicated. As consumers, we are faced with a bewildering choice of pain relief options. But why? Within the Nurofen range we have Nurofen for back pain, Nurofen for tension headaches, Nurofen for migraines, Nurofen for period pain, Zavance. Within the Panadol range we have Panadol back and neck, Panadol rapid, Panadol Osteo. And then we face the choice of gel caps, caplets, tablets, soluble tablets … So is there really a difference in these types of products or is it just a marketing ploy that leaves our homes resembling a pharmacy? The short answer is … the latter! While there are some small differences between products mostly this is marketing.Generally speaking, all of these products contain the same amount of active and will provide approximately the same level of pain-relief as the next box of Panadol or Nurofen. Nurofen for tension headache, period pain and back pain all contain exactly the same medication at the same dose (342mg of ibuprofen lysine which is equivalent to 200mg standard ibuprofen). Target practice Put simply, Panadol and Nurofen (and other equivalent brands) are unable to “target” specific regions or types of pain. These medications works by blocking enzymes (everywhere in the body, not just the area the is currently painful) which help to make chemicals called prostaglandins.. Less prostaglandin means less pain and inflammation. It is not known exactly how paracetamol works but it does not reduce inflammation. Paracetamol is used to treat pain. The type of painkiller you need depends upon the type of pain you have. Paracetamol is normally suitable if your pain is not too serious and you do not have inflammation whereas medications such as Nurofen are generally recommended for people who have pain and inflammation, as might be the case with back pain. Thus if you take the Nurofen specifically for period pain it will works in exactly the same way and produce the same amount of pain relief for a tension headache. The main difference between the products is in relation to how quickly our bodies absorb the medication (how quickly it is going to work or for how long they work (if the product is sustained or immediate release). There are a multitude of techniques drug companies use to increase the rate medications are dissolved in the stomach and thus absorbed into the blood stream. Examples include using water-soluble salts such as ibuprofen lysine versus ibuprofen acid (standard ibuprofen), or having it already in a liquid form – gel capsule versus solid tablet. Or they even might add extra ingredients, such as Panadol’s patented technology that “allows the tablet to start disintegrating in as little as five minutes”. Know your pain The choice of whether to take paracetamol or ibuprofen should be highly dependent on the pain you are suffering from (ibuprofen has more anti-inflammatory properties than pain-relieving, whereas paracetamol relieves pain rather than inflammation) and what other tablets you are taking or medical conditions you have. So, instead of stocking up your bathroom cupboards with every type of pain relief under the sun it is important to check which medication is most appropriate for you. Your pharmacist can help with this. Although manufacturers of paracetamol or ibuprofen always stress how safe these medications are, it’s vital you follow the directions written on the packet closely. To start, only take the recommended maximum number of tablets each day. This is no more than 4 grams of paracetamol or 1.2 grams of ibuprofen (two tablets three times a day). Many cold and flu preparations also contain pain relievers so it is important you keep track of the total amount of paracetamol or ibuprofen you are taking throughout the day. Exceeding the maximum dose of paracetamol can lead to liver toxicity; whereas exceeding the ibuprofen daily dose can cause severe irritation to the gut lining. In addition, there are a few health conditions in which ibuprofen should be taken with caution. Like aspirin, ibuprofen can trigger an asthma attack in some asthmatics. People with high blood pressure or history of gastric ulcer/severe heartburn should avoid taking ibuprofen because this medication may worsen both conditions. Ibuprofen can also increase the blood-thinning action of aspirin, warfarin and other anticoagulants. As always, be sure to check with your pharmacist if you’re in any way uncertain about dosage, and even whether you should be taking a given drug. And just remember, regardless of the marketing these drugs can’t “target” a specific type of pain.