How to choose the right pain medication? How do the tablets differ from each other? Consults the assistant of the Department of Clinical Pharmacology of the Voronezh State Medical Academy Yulia Mikhailovna Dronova.
Correct approaches
The main thing in the use of analgesics is not to forget that you need to identify and eliminate the causes of pain. For many ailments, pain relievers are not needed at all.
So, with menstrual pain and intestinal colic, it is often enough to use antispasmodic drugs - for example, no-shpy. Pain in the intestines due to gas accumulation effectively reduces espumisan.
Comment on the article "Painkillers. How to choose pills for pain?"
I work in the production of chemicals. I confess - I do not always eat TB, and this time I breathed some rubbish. my head ached for the rest of the day. In the evening my wife gave me Nimesan. Of course, I tried at first - I never heard of them. and even some triangular pills. I drank half - it became easier. immediately accepted the second. let go quickly, and the head no longer bothered. Citizens, observe safety requirements!
22.11.2017 23:22:41,Plus to ibuprofen, he helped me more than once. And she also took it to the child in the form of an Akrihinov suspension, it is quite inexpensive and saves from pain well, and it is harmless.
13.09.2016 17:34:28,Great, I just have pink Nurofen for pain during menstruation, and it is made on the basis of ibuprofen. It quickly relieves of pain, it also turns out to be safe :) Good news :)
03.12.2014 15:52:36,Total 8 posts .
More on the topic "Pain pills":
The second day I have a headache, ordinary painkillers do not help: Nurofen 400, Panadol 500, Spazmalgon, Noshpa. Advise what to drink so that the pain goes away? The pressure is normal, the temperature is not. I made an appointment with a neurologist for tomorrow.
Citramon, which I drink, does not help my daughter. The rest of the headache medications at home are very powerful. I realized that I could not figure out what is reasonable to give to a teenager?
The doctor told us that we can take citramone or nosh-poo. I was even afraid of tsitramon, I gave her a pill of burden .. Katyuha says that it’s not better (now she’s asleep, everything is normal) ..
We were discharged from the hospital today. Displaced humerus fracture (two needles), the child's arm has been hurting for a week. In the hospital, they drank analgin for three nights, but it does not really help. Yesterday I gave Nurofen liquid, the effect is so-so. Doctors say, like there is nothing to hurt there, you are doing well, bear with it. But the child does not sleep, he almost puts his hand down - he sobs at night mostly.
The youngest son (11.5 years old) had braces installed yesterday, the doctor warned him about pain, when asked which pain relievers are better, he said analgin. Well, gave, of course, helped, but if the pains are strong enough last for several days - what, like analgin and give? ... Maybe someone had a good experience with other painkillers for this age? Or at least there is some information that is less harmful of such drugs with good intensity of action.
when it all began and I was 13 years old, my periods came, though not regularly, but without pain at all. at school all the girls were jealous. now I'm 25, and every time is like torture for me. vomiting, pain in the lower abdomen. today I had a "fun life" from 4 to 6 in the morning. I drank the pill, but it didn’t help. I can only be in one position, from the side it looks probably funny. I know that many suffer on the first day. is this the norm? and why are we girls ((((
I am going to treat a tooth, with anesthesia, but the injection itself is painful, and it still hurts when, when cleaning the canal, the needle goes beyond the root into the jaw. Is the subject worth it?
Son of 11 years old, congenital hypertensive syndrome, treated, almost does not bother ... "Almost" - is expressed in the fact that now, for example, autumn, the weather is constantly changing, at school gets tired, etc. etc ... sometimes (yesterday, for example) complains of a severe headache. Is it possible to give a child something to drink just to help relieve a headache?
Does headache relief help? otherwise there is nothing more harmless with GW, and the little head is aching ...
I'm not sick at all. in my medicine cabinet there were always only 2 types of tablets - activated charcoal - "from the stomach", and citramon - "from the head". But I have already heard many times that citramone is the last century, and that it is even more harmful than useful, supposedly has a bad effect on the liver. I just want to ask, who have some kind of on-duty pills "from the head" in the cosmetic bag? What are modern people using now?
From pain during menstruation (wild!), So as not to irritate the stomach. Recently, Ibuprofen has been turning out something, although I always take it after meals, but I would like to be able to drink it right away in the morning on an empty stomach. What's better?
Updated: 16.05.2019 12:25:53
Expert: Boris Kaganovich
* Review of the best according to the editors of the site. On the selection criteria. This material is subjective, does not constitute advertising and does not serve as a purchase guide. Before buying, you need to consult with a specialist.
Analgesics, or pain relievers, belong to the so-called symptomatic treatments. They reduce the symptom, relieve suffering. As a rule, they do not affect the cause of pain.
It is known that there are several types of treatment. Etiotropic therapy acts on the cause, for example, antibiotics destroy pathogenic microorganisms. There is pathogenetic therapy, when the drug eliminates, interrupts the pathological process of the development of the disease. So, anti-inflammatory nonsteroidal drugs, which will be adequately represented in today's rating, are able to reduce inflammation. The patient's condition is relieved, the reddened and swollen joint becomes normal in color, the swelling subsides, and the pain subsides.
There will be several different groups of drugs in this ranking of analgesics. Almost all of them are available over the counter. Of course, there are no leaders in pain relief such as Omnopon, Promedol, Tramadol and other drugs belonging to the drug group in the ranking. It is just that narcotic painkillers are not needed by the patient on an outpatient basis, but are prescribed after surgery in a hospital. In the case of an inoperable oncological disease, they are prescribed as symptomatic remedies according to special prescriptions, and this is also a separate story.
Rating of the best pain relievers
| Nomination | a place | anesthetic drug | price |
| best pain relievers injection | 1 | 240 ₽ | |
| 2 | 45 ₽ | ||
| 3 | 211 ₽ | ||
| 4 | 889 ₽ | ||
| Best Analgesics for Oral Use | 1 | 43 ₽ | |
| 2 | 149 ₽ | ||
| 3 | 319 ₽ | ||
| Best Pain Relievers for Topical Application | 1 | 460 ₽ | |
| 2 | 676 ₽ | ||
| 3 | 366 ₽ | ||
| 4 | 240 ₽ | ||
| 5 | 230 ₽ |
Caution, analgesics!
Before starting a conversation about painkillers, or analgesics, you need to remind readers that IP Pavlov not in vain called pain "the watchdog of the body." If you put him to sleep, you can miss a serious enemy. Therefore, it is advisable in no case to use analgesics for acute chest pain radiating to the arm associated with shortness of breath. In this case, the use of nitroglycerin and aspirin can prevent myocardial infarction, and the pain reliever will only worsen the condition.
Analgesics in tablets, or more powerful drugs for intramuscular administration, are categorically contraindicated in acute and new-onset abdominal pain. There is a high risk of developing an acute purulent process, ulcerative bleeding, followed by hemorrhagic shock. In case of acute abdominal pain, only myotropic antispasmodics can be used, which will help with an attack of hepatic and renal colic, but will not lull the surgeon's vigilance, and will allow timely emergency surgery to be performed in a timely manner.
Therefore, basically, this material will be useful for those people without medical education who are looking for drugs to treat headaches, toothaches, reduce pain in the joints after injuries, bruises and dislocations. But even so, pain relievers can only be used with familiar pain. For example, no one forbids smearing a bruised knee with Fastum gel, or trying to cope with a familiar migraine attack with another medicine.
But, for example, if there is an acute bursting headache, vomiting, sound and photophobia, convulsions appear, then this may indicate the occurrence of meningitis, and you need to call an ambulance. In one word, any unfamiliar, suspicious, severe pain accompanied by symptoms strange for a person is a reason for an urgent visit to a doctor or calling an ambulance.
Best pain relievers for injection
Injectable dosage forms are always prescribed for severe pain syndrome. And then, as it decreases, they switch to pills, and then generally remove the drugs that enter the bloodstream. A classic example of this is an exacerbation of a herniated disc, which most often occurs with sudden movement, turning, lifting, or hypothermia. The first two to three days, with acute pain, injection forms of drug administration are shown, then - a week, on average, pills, and then only local remedies and physiotherapy procedures. Below are the most popular injectable painkillers in injection form. Of these, Ketanov is prescription, and the rest can be purchased as a free pharmacy supply.
Ketanov (ketorolac tromethamine)
This pain reliever, according to the tacit opinion, is one of the most powerful and well-proven in various fields of medicine. Ketanov helps with joint pain, back pain, exacerbation of rheumatism, muscle pain, neuralgia, and also as a drug that alleviates the patient's condition after surgery.
In addition to the pronounced analgesic effect, this agent slightly relieves inflammation and slightly reduces the feeling of heat, since it belongs to non-steroidal anti-inflammatory drugs. However, as an antipyretic drug, it does not work enough and weakly, and in this case, paracetamol will help best. But in terms of the analgesic effect, Ketanov can even compete with morphine, and is able to stop even severe toothache and postoperative pain. However, it does not depress respiration and does not cause drug dependence.
Ketanov is produced in ampoules for intramuscular administration in one milliliter. You can use this drug, they put deep intramuscular injections, and at the same time it is advisable to do with one injection per day, that is, use it in the minimum dose. But it must be remembered that young and healthy people under 65, depending on the severity of pain, cannot exceed a single dose of 30 mg, that is, you cannot put more than 1 ampoule at a time, but the daily dose cannot exceed 3 ampoules per day. In addition, you cannot continue the course of treatment with Ketanov using injections for more than 5 days. The Romanian company Terapiya produces Ketans in ampoules, and a pack of 10 ampoules of 1 ml costs 106 rubles.
Advantages and disadvantages
The advantage of Ketanov will be the ability to quickly and efficiently relieve any pain syndrome, but at the same time its therapeutic breadth is rather narrow. A single dose should not exceed 1 ampoule, and a daily dose should not exceed 3. At the same time, in case of an overdose, it can stimulate an exacerbation of erosive-ulcerative gastritis and has a number of contraindications. It should not be prescribed to patients with aspirin asthma, hemophilia with hemorrhagic stroke, children under 16 years of age, pregnant and lactating women. But in the event that it is prescribed according to indications, for example, due to joint dislocation, toothache after tooth extraction, then it is able to improve the quality of life, reduce and even completely eliminate pain syndrome.
Diclofenac, which is produced in ampouled form by the Serbian company Hemofarm, is very cheap: 47 rubles for 5 ampoules. By the way, the Russian company Biochemist also produces exactly the same ampoules, 3 ml each, but the package contains 10 ampoules, and at the same price. It is up to you to decide which packaging to purchase according to the doctor's prescription - a small Serbian one, or a large domestic one, but a small one is better.
Diclofenac is an honorary "grandfather" in the family of non-steroidal anti-inflammatory drugs, and, despite its rather low safety spectrum, it is still loved and used. It is necessary to prescribe Diclofenac for a variety of diseases of the musculoskeletal system, for arthritis, for ankylosing spondylitis, in dentistry and orthopedics, it also finds application. Gynecologists prescribe it for algodismenorrhea, that is, for painful menstruation. But most of all it is used by neurologists, traumatologists and orthopedists. Many variants of osteoarthritis, acute back pain, neuralgia and radiculitis, exacerbation of protrusion of intervertebral hernias - this is not a complete list of indications for the use of Diclofenac.
It is very important to remember that a single dose is equal to 1 ampoule. The agent must be injected deeply intramuscularly, the drug can be repeated no earlier than 12 hours later. Diclofenac injections can be treated for no longer than 2 days. In other words, purchasing a package of 5 ampoules is the best solution when it comes to sudden and short pain syndrome.
Advantages and disadvantages
If Diclofenac had no drawbacks, then it would have cost much more, since it very effectively relieves inflammation and fights pain, but it is not in vain that the drug is limited to two days. It is capable of causing gastritis, inflammatory bowel changes, pancreatitis and liver necrosis, fulminant, that is, fulminant form of toxic drug hepatitis. It is very dangerous to use Diclofenac for ulcers, patients with various forms of gastritis, and especially erosive and ulcerative. Therefore, if necessary, they are "covered" with omeprazole tablets.
Headache, dizziness, skin rashes, and other side effects are common. In addition, the official instructions contain an impressive list of contraindications that must be taken into account by the doctor, and especially when it comes to elderly patients. But with all this, short courses of Diclofenac are able to put a person on their feet even with an acute pain syndrome, and its cheapness and good quality of the imported drug makes it a competitor to even stronger drugs.
Ketonal is a more advanced pain reliever than Diclofenac, the next generation. Its active ingredient is ketoprofen, and each 2 ml ampoule contains 100 mg of it. It is indicated for use with severe pain syndrome of various origins, while of course, first of all, it is a lesion of the musculoskeletal system. These are bursitis and tendonitis, osteochondrosis and gout, rheumatoid arthritis and ankylosing spondylitis, psoriatic arthritis. Also, this remedy is used for pain syndrome due to malignant neoplasms, for migraines, headaches and radiculitis.
Ketoprofen in ampoules should be used no more than two ampoules per day. It is desirable that the course of treatment with ketonal does not exceed 3-5 days, and it is advisable to use the medicine in the smallest dosages that bring an effect, for example, 1 ampoule daily in the evening for 3 days. Ketonal is produced by the Lek company from Slovenia, and a package of 10 ampoules costs 227 rubles on average.
Advantages and disadvantages
The big plus of Ketonal is the permission of the official instructions to use it during pregnancy, of course, with extreme caution, and as short a course as possible. It should not be used only in the third trimester, when labor may be impaired. Contraindications to the use of the drug are about exactly the same as in other cases. In addition to hypersensitivity, it is an allergy to NSAIDs, that is, a combination of aspirin asthma, nasal polyposis and aspirin intolerance. This is an exacerbation of peptic ulcer disease, low blood clotting, childhood, severe hepatic and renal failure. It is contraindicated with a high risk of various bleeding. But in the event that it is prescribed in a short course in the absence of contraindications, then it is just as capable of bringing significant relief to patients with pain syndrome of the most varied genesis.
Movalis, or Meloxicam, is the last drug we have considered for deep intramuscular injections to relieve pain and inflammation, the first to be discovered from the group of oxicams - COX 2 inhibitors. Movalis is the original meloxicam drug produced by the German company Boehringer Ingelheim, and the packaging is 3 ampoules will cost 850 rubles. Movalis belongs to the group of non-steroidal anti-inflammatory drugs, it is able to reduce all the classic signs of inflammation: redness, fever, soreness and swelling. The action of the drug is based on the blockade of prostaglandin synthesis.
Shown as a remedy for diseases of the musculoskeletal system, various forms of arthritis, arthrosis and osteoarthritis. The classic indications for Movalis are acute pain in the lower back, lumbago, other forms of dorsopathy, shoulder periarthritis and other diseases. In the case of uncomplicated pain syndrome, for example, with osteoarthritis, one 1.5 ml ampoule containing 7.5 mg of Movalis is injected intramuscularly. In severe cases, two ampoules are administered per day, for example, in rheumatoid arthritis. You cannot enter more than two ampoules daily, that is, more than 15 mg.
Advantages and disadvantages
The drug is packaged in 3 ampoules: this is quite enough for three days of primary relief of acute pain syndrome. Contraindications and side effects in Movalis are typical for all NSAIDs, they have been repeatedly named above, and we will not dwell on them. Of course, the high cost of the drug is striking: one ampoule for injection costs 283 rubles, and one ampoule of diclofenac, even if you take an expensive imported package, will cost 8 rubles. We find that the cost of one day of treatment with diclofenac is 32 times cheaper than one injection of Movalis. This is exactly the situation that was described above. If diclofenac didn't have so many side effects, it would be much more expensive. This is not expensive Movalis, this is Diclofenac too cheap.
The best analgesics for oral use
The group of pill analgesics, of course, includes non-steroidal anti-inflammatory drugs - NSAIDs. But, as you know, the reactivity of various chemicals with each other in solid form is much less than in solution. And if it is strictly forbidden to mix in ampoules, as well as in syringes, various solutions before administration, then tablet preparations have the most pronounced effect, being combined.
So, doctors and pharmacologists have long noted that if you combine the reception of paracetamol with ibuprofen, then it will have an analgesic effect in 70% of the subjects. Ibuprofen is also effective along with caffeine. Paracetamol with aspirin also has a slight but well-documented analgesic effect. It is important that such a combination of various drugs with each other makes it possible to significantly reduce the dosage of each of them, but at the same time, the medicinal effect sometimes developed faster than in the case of one drug. Consider what modern and popular drugs in tablets exist that have an analgesic effect and are included in the rating for this reason.
Askofen with the letter "P" is a triple drug. It combines aspirin, caffeine and the inexpensive non-steroidal anti-inflammatory drug paracetamol. Askofen-P has a low analgesic effect. Therefore, it is indicated for mild pain. The classic situation: a planned visit to the dentist, tension headache, mild pain in the lower back or in the muscles.
In this case, it is quite enough to use it one tablet at a time, from 2 to 3 times a day. The maximum dosage during the day is 6 tablets. In the event that the patient has a risk of stomach or duodenal ulcers, then it is necessary to minimize the irritating effect of caffeine on the gastric mucosa. Therefore, the remedy is taken after a meal, and it is advisable to drink it with mineral water or dairy or lactic acid products. The pain reliever is very cheap. It is produced by the Russian company Pharmstandard, and a pack of 10 tablets can be bought for only 27 rubles.
Advantages and disadvantages
What are the advantages of a drug that has a weak analgesic effect? So many. Firstly, it slightly tones up due to the caffeine introduced into the recipe, and, if taken in the morning, can reduce tension headaches and enhance daytime performance when working at a computer. In addition, the drug is found everywhere in pharmacies and is cheap. But still, side effects such as decreased appetite, allergic skin rashes, abdominal discomfort and even diarrhea can develop. But they are dose dependent, and if the dosage is not exceeded, then nothing will happen.
Ibuklin is fully working out his declared abilities. This is a good Indian medicine, comes in a pack of 10 tablets, and is inexpensive - only 130 rubles. This is one of the combination drugs discussed in the introduction to this section. It contains paracetamol and ibuprofen. Each capsule contains approximately equal amounts of them: about 400 mg. It is this relationship that contributes to their mutual enhancement of efficiency.
This drug helps with algodismenorrhea, with various forms of toothache, and aching joints, which quite often occurs with various infectious diseases, such as the flu. It is necessary to take the drug one tablet, three times a day, it is taken regardless of food intake. This dosage - 3 tablets per day - is the maximum, and should not be exceeded. In addition, Ibuklin should not be taken for longer than 5 days. Ibuklin is produced by the Indian company Dr. Reddis.
Advantages and disadvantages
A big plus of Ibuklin is speed, so he may well be worn in a handbag to work. It helps to reduce the severity of pain in many conditions. However, it should be remembered that, like other non-steroidal anti-inflammatory drugs, it cannot be used with a high risk of gastric bleeding, with low blood clotting, in case of intolerance to aspirin, as the main representative of the NSAID group, in old age against the background of chronic liver and kidney damage, in pregnant and lactating women.
But usually long-term use is not required. Just one or two days of taking Ibuclin are usually able to put a person on their feet, and in more difficult cases, you need to see a doctor.
Above, in the section for ampullated drugs, we have already indicated ketoprofen, or Ketonal. Dexalgin is a slightly modified ketoprofen with increased activity. A big plus of Dexalgin is a short but quick and powerful analgesic effect. So, in patients after tooth extraction, if you take Dexalgin, then after half an hour there is a significant relief.
The analgesic effect lasts for about 5 hours, but sometimes one dexalgin tablet is enough for 8 hours. Therefore, in the event that you have any planned interventions related to pain, then you can take this remedy in advance, about an hour in advance, with a preventive purpose. This can be a planned visit to a traumatologist, dressing, removal of stitches, a visit to the dentist. In addition, this anesthetic is also used in other cases to relieve migraine attacks, treat other forms of headache.
A distinctive feature of Dexalgin is the form of release. These are not tablets, but granules, from which a solution is prepared. Of course, it is absorbed into the bloodstream faster and acts faster. 25 mg sachets of the drug. A patient with severe pain should take one sachet three times a day, after 8 hours, but not more often and not more. In total, Dexalgin is taken within 5 days. It is produced by the Berlin-Chemie company, and one package of 10 sachets, designed for three days, can be bought for 323 rubles.
Advantages and disadvantages
As mentioned above, a strong plus of Dexalgin is a fast and powerful action. But still, it does not last so long. 8 hours is the maximum maximum noted by the volunteers, at which they still had at least some positive effect of the drug. Still, in clinical practice, it is better to focus on a shorter time frame. It's four or even three hours. Therefore, if you have an attack of toothache, for example, in the evening, and in the morning you are going to the dentist, then this drug will help you fall asleep, but still in the middle of the night you can wake up from a toothache. It will expire. We will not describe all contraindications, since they are very typical for other forms of NSAIDs and have been described above. But still, Dexalgin is a powerful, but short-acting remedy.
The best pain relievers for topical use
Local ointments, creams and gels, as mentioned above, are used to relieve moderate pain syndrome in the areas of joints, ligaments, with closed injuries and bruises of the extremities, with myositis, muscle stretching - with disorders of the musculoskeletal system. There is usually continuity. Initially, in case of severe pain, injections are used. Then in tablets, and then, together with the tablets, local preparations are added to them. Consider the most popular and effective creams and gels with anesthetic effect sold in Russian pharmacies in the spring of 2019.
Ketonal Cream is a topical form of pain reliever produced by the Swiss company Sandoz, and is the same as the ampouled Ketonal. It contains ketoprofen. It is important that the substance from the cream is practically not absorbed into the bloodstream and does not accumulate in the body. It penetrates only into the depths of the skin and subcutaneous tissue, into the ligaments and muscles, and accumulates there, and not in the bloodstream. It is indicated for all diseases of the musculoskeletal system, ranging from neuralgia and radiculitis, and ending with psoriatic arthritis and traumatic injury: rupture of tendons and ligaments, muscle contusion.
For external use, it is applied in a small strip, no more than 5 cm long, and rubbed in with massaging movements. Frequency rate of application - up to three times a day. Treatment without consulting a doctor should not last more than 2 weeks. A tube weighing 30 g will cost about 280 rubles.
Advantages and disadvantages
The advantages of Ketonal cream are that it is quickly absorbed, in contrast to medicinal ointments. The ointment is only on the skin, but it is absorbed within a few hours, while Ketonal Cream is absorbed very quickly and does not stain clothes, so it can be used at work. However, it has contraindications. These are hypersensitivity to salicylic acid, wounds and trauma to the skin, the presence of eczema and dermatitis. It is not used if the patient has bronchial asthma, including that caused by taking aspirin. It should not be used in people who overreact to ultraviolet rays of the sun, during and after irradiation in a solarium, in the third trimester of pregnancy, up to 15 years of age.
As we talk about local pain relief creams, we meet our old friends. So, a good imported drug Voltaren Emulgel is nothing more than Diclofenac, which is already dispensed not for intramuscular injections, but in a special emulsified form. In this case, such a gel-like consistency already protects the patient from a systemic reaction much more. Of course, Voltaren is still absorbed into the bloodstream, but only in an amount equal to one percent. And even then, in the event that a very large area of skin is smeared with an area of 400 square centimeters: this is the area of a large joint.
Therefore, Voltaren Emulgel can be used with greater safety than the same drug, only in ampoules. This remedy is prescribed for various pains in the back and joints, for swelling and inflammation of soft tissues, for bursitis and tendovaginitis. Unlike domestic diclofenac in ampoules, Voltaren Emulgel is not at all a cheap remedy. So, one tube of gel weighing 50 g, which is produced by Novartis, will cost, on average, 480 rubles.
Advantages and disadvantages
The advantages of Voltaren Emulgel exceed its disadvantages. Of course, some contraindications remain, but they are much less in comparison with intramuscular administration of the drug. In addition to hypersensitivity, bronchial asthma and aspirin intolerance, this is pregnancy, breastfeeding and childhood. As for erosive and ulcerative lesions, the risk of gastric erosion, in case of blood clotting disorders, the drug can already be used, but only with caution. The fact that from contraindications a lot of diseases have migrated to the category "with caution" and made it possible to increase the price of Diclofenac. The number of readings increased. But, on the other hand, Emulgel spreads so well in a thin layer that a tube of 50 g will last for a long time. Therefore, the savings here are quite obvious.
Dolobene is a drug that does not contain non-steroidal anti-inflammatory components. This is the only one of these pain relievers in our rating. It includes Dexpanthenol as a dermatotropic agent, heparin as an anticoagulant, and dimethyl sulfoxide, known to all as Dimexide. Dolobene has an analgesic, anti-inflammatory and anti-edema effect at the same time. In addition, Doloben contains rosemary, mountain pine and citronella oil. This gives it a slight chill and pleasant aroma when applied.
Dolobene is indicated for myositis, dislocations, various traumatic injuries, synovitis, stretching of the tendons, in case of acute back pain. Thus, Dolobene can be considered a companion of active people and athletes. It should be applied in a thin surface layer, 2-4 times a day in the required place. You can also apply the drug under the bandage. Dolobene is produced by the German company Ratiopharm, and a tube of 50 g is, again, not cheap: 430 rubles.
Advantages and disadvantages
Dolobene's advantage will be the ability to use it as a cream for sports massage when adding a small amount of vegetable oil. In addition, it can be used in various types of electrophoresis, including as a drug that migrates in the tissue, and is applied under the cathode. Also, in the case of using various methods of phonophoresis, or ultrasound treatment, Dolobene is used as a contact gel. Ultrasonic waves complement the action of the active ingredients of this good remedy. As for side effects, sometimes they are due to the presence of Dimexidum, and most often come down to redness and an itching sensation, which soon passes. The same side effect of Dimexide, associated with the presence of sulfhydryl compounds, is a slight garlic odor from the mouth in a patient shortly after Dolobene is applied over a too large area.
Finally, you can consider Viprosal B. This ointment contains viper venom, and such medicinal ointments and creams are quite common not only in folk medicine, but also recognized by the scientific community. You can also name Nayatox, which also contains snake venom, Apizartron, which contains bee venom. In this case, in addition to the venom of the viper, salicylic acid, camphor and natural gum turpentine are added. Camphor cools, turpentine is a little irritating, and salicylic acid accelerates the penetration of the poison into the depths of the tissue.
Viprosal B is indicated for various joint pains, for chronic myofascial syndrome, when the muscles of the back are compacted, and their tension and stiffness occurs. Also, the ointment can be used in the complex therapy of various neuralgias, in the treatment of acute pain in the back.
It can be used in adults and in children who are over 10 years old, and usually a single dose of the ointment should not exceed 10 g, that is, one or two teaspoons. You need to use it from 1 to 2 times a day, rub it into the skin completely, and if there is no allergic reaction, then Viprosal B can be used until the pain syndrome disappears. Naturally, the skin must be intact. Viprosal is produced by the Estonian company Grindeks, and the cost of one tube with the same weight of 50 g is, on average, 312 rubles.
Advantages and disadvantages
Snake venom has long been used in folk medicine. But nevertheless, it must be borne in mind that blood thinning agents cannot be used in case of a tendency to hemorrhagic strokes, bleeding, in the presence of damage to the skin. We must not forget that this is a local irritant. Therefore, it should not be applied to the skin in patients in a febrile state, in persons with tuberculous lesions of the lungs, with impaired renal and liver function. Usually, the ointment is well tolerated, but in rare cases, itching, hives, or swelling may occur. Then you need to complete self-treatment and consult a doctor.
Finally, in conclusion of the rating, it is necessary to tell at least one representative of also local anesthetic drugs, but not analgesics, but anesthetics. This is Lidocaine asept spray, which, in addition to lidocaine hydrochloride, contains chlorhexidine as an antiseptic. This solution is in the form of a spray, transparent, with an alcoholic odor, and also a slight mint aroma. Everyone knows that local anesthetics are used for pain relief in dentistry, during minor surgical operations, and they block pain impulses. Usually, after applying lidocaine to the mucous membranes, a characteristic effect of numbness develops, and everyone who has been treated by the dentist will remember this unpleasant sensation after "freezing". This effect lasts for about 15 minutes.
Lidocaine in the form of a spray can be widely used not only by dentists, but also independently, for example, in case of ulcerative stomatitis, when ulcers appear on the oral mucosa, and the process of eating becomes extremely painful and painful. And after spraying lidocaine on the oral cavity, although numbness occurs, but you can painlessly swallow food. Also, the agent is used when treating small wounds, in the case of deep and painful cracks in the skin, when treating burns, various bites, such as animals or insects. Indeed, in addition to lidocaine, the composition also includes the antiseptic chlorhexidine.
But it is imperative that after being bitten by animals, both domestic and wild, you should contact the emergency room to administer the rabies vaccine against rabies. Lidocaine Asept is produced by the domestic company Biogen. One 50 ml bottle costs, on average, 309 rubles.
Advantages and disadvantages
Lidocaine asept spray is very convenient, and it can always be at hand: in the country, on a hike. However, it cannot be used if there are cardiac arrhythmias, severe liver disorders, epilepsy, as well as children under the age of 8 years. There is a purely economic "nuisance". So, if you buy 20 ml Lidocaine in the form of ampoules, then its cost will be 36 rubles. As for chlorhexidine, its cost in the form of a solution for external use with a volume of 100 ml will be only 12 rubles. Here, having mixed "penny" chlorhexidine with lidocaine in one bottle, the domestic company made a significant profit on consumers. What did she do? Added mint essence for the scent, packaged as a spray, and increased the price 10 times.
Constant severe pain not only harms health, but also destroys the human psyche. Acute pain sensations appear suddenly and for a long time. They can be caused by injuries, fractures, damage to internal organs, and dental problems. Pain relievers can quickly deal with these attacks, some of which can be purchased without a prescription.
Strong analgesics are often required to stabilize the attack.
They are divided into several groups:
- non-steroidal anti-inflammatory drugs;
- weak narcotic substances;
- strong narcotic medicines.
The last two groups are sold by prescription only. These medications do not cure or eliminate the cause of the symptoms, they simply relieve pain for a while.
Many of them have unpleasant consequences, for example, drugs based on morphine, relieving an attack and improving the condition, cause addiction and psychological dependence: a person has a constant need for such pills.
Narcotic drugs are used only in difficult cases, for example, with burns of a significant part of the body or the development of tumors. It is difficult to buy them even with a prescription. Non-narcotic pain relievers do not cause the described negative consequences, but, unfortunately, they have a rather weak effect.
What is the strongest pain reliever for different types of pain
In the treatment of inflammatory processes, doctors use non-steroidal drugs. They can be produced in one of the following forms - tablets, ampoules or suppositories. When prescribing, indications and contraindications for use are taken into account.
You should not use them if human activities require full concentration of attention and a good reaction. In addition, after taking them, drowsiness and weakness appear. The dosage of admission is also determined by the attending physician, and their uncontrolled intake can be harmful.
The most effective antispasmodics are:
Pyrazolones
Pyrazolones include derivatives that combine analgesic, anti-inflammatory and antipyretic effects of varying strength. A common drug is analgin, the main function of which is to eliminate many types of pain. 
Despite the high popularity of the drug, experts note the low safety of its use. Long-term use of metamizole sodium negatively affects the blood composition, so it should be used only when absolutely necessary. Baralgin M, Analgin-quinine, Baralgetas and Spazmalgon are also popular.
The last 2 drugs are effective in combating the following symptoms:
- pain arising from vascular or muscle spasms;
- periodic migraines;
- renal and biliary colic;
- signs of fever;
- if it is necessary to lower the pressure;
- to reduce the tone of the uterus in women in position.
Combined analgesics
Paracetamol is the most famous combination analgesic. 
In addition to it, the following medicines are used:
| Drugs | Short description |
| Vicks Active | The medicine has paracetamol and phenylephrine among its constituent components. It not only reduces joint and muscle pain in colds, but also relieves nasal congestion. |
| Brustan, Ibuklin and Ibuklin Junior | These medicines have anti-inflammatory and pain-relieving properties. In addition to paracetamol, they contain ibuprofen. Due to the verified combination and dosage, Brustan and Ibuklin give an analgesic and antipyretic effect. |
| Butadion | Strong non-steroidal anti-inflammatory drug. It is absorbed into the bloodstream from the esophagus rather quickly. Already 2 hours after administration, its effect begins. Butadione is excreted slowly from the body. The drug has anti-inflammatory and analgesic effects. Produced in tablets. |
Strong pain relievers in this category have many side effects. In some countries, they are not only not sold by prescription, but are completely banned.
Anti-migraine drugs
The headache that accompanies migraine attacks often leads to nervous exhaustion and inability to work: the slightest movement responds with wild pain. Before taking medications that are highly effective and block such pain, you should conduct an examination and confirm the diagnosis. The choice of the drug and its dosage depend on the patient's individual tolerance. 
Strong over-the-counter pain relievers in this group are as follows:
| A drug | Description |
| Aspirin | The simple pain of this remedy will subside after a couple of hours. You can take the drug 4 times a day. Aspirin thins the blood, so it should not be used for bleeding and stomach ulcers. To increase the effectiveness, it is necessary to double the dose of the drug. It is permissible to drink the medicine with tea. |
| Ibuprofen | These tablets are drunk no more than 4 times a day. Ibuprofen is harmless enough to be prescribed to pregnant and lactating women. The schedule of admission and dosage is chosen by the attending physician. |
| Diclofenac potassium | Available in suppositories, powders and injections. The drug is rapidly absorbed. |
For intense headaches, the usual analgesics are not effective. In these cases, a prescription is written for stronger drugs that constrict the vessels of the brain and restore blood circulation.
Anti-migraine drugs can quickly relieve pain, but they are not available over the counter and are expensive. For problems with blood pressure and heart, such medications should be taken with extreme caution.
List of the best NSAIDs
Among the most popular non-steroidal drugs, the most effective are:
Some of them are more powerful, others - only temporarily stop the symptoms of the disease.
In addition, scientists are developing new drugs that are devoid of the side effects inherent in conventional drugs. Their main disadvantage is their high cost. Movaliz, nimesulide belong to the drugs of the new generation.
COX-2 inhibitors
COX 2 inhibitors are "new" generation drugs. They are divided into drugs with COX 2 inhibition (nimesulide, meloxicam) and highly selective COX 2 inhibitors (celecoxib, rofecoxib).
The indications for taking inhibitors are broad. They are prescribed to remove pain symptoms, relieve toothache, joint pain, neurological and menstrual pain, as well as relieve pain shock in the postoperative period.
Strong pain relievers, which can be bought without prescriptions in pharmacies, have the following contraindications for admission:
The drugs of the new generation of the non-steroidal group are considered the most effective in many countries. They quickly cope with their task, but they can only be purchased with a prescription: the reception requires strict control.
Narcotic analgesics
Painkillers that depress the nervous system and thereby relieve pain are classified as narcotic drugs. Despite the contraindications and the possibility of addiction, sometimes you simply cannot do without them.
There are the following subspecies of funds:
These medicines are prescribed exclusively by a doctor in accordance with the severity of the course of the disease and the individual characteristics of the body. Buprenorphine is a typical member of the group. It is a synthetic pain reliever. It appeared on the market relatively recently, but has already established itself as a potent analgesic with a minimum number of side effects.
The indication for prescribing narcotic drugs is:
- oncology in the last stage;
- the need to relieve postoperative pain;
- shock after severe trauma and myocardial infarction;
- difficult childbirth;
- renal colic;
- persistent dry cough.
It is forbidden to take them with high pressure and respiratory distress, they are not prescribed for children under 2 years of age. Store these medicines in closed first aid kits. Overdose can cause respiratory arrest, loss of consciousness, and death.
List of effective pills for inflammatory pain
Strong over-the-counter pain relievers for pain associated with inflammation are readily available. All these drugs differ in composition and mode of action. 
| A drug | Short description |
| Nurofen | Tablets 0.2 mg. Designed to relieve the following pain:
The medicine is taken by adults at 6, and by children at 4 tablets per day, at intervals of 6 hours. |
| Nalgezin | Tablets of 0.275 mg. They have analgesic, antipyretic and anti-inflammatory properties. The drug is prescribed:
The reception features are as follows:
On average, you should take no more than 4 tablets per day. The dosage and schedule of admission is determined by the doctor. |
| Ibuklin | The drug is available in tablets of 60 pcs. packaged. Ibuklin is indicated for:
It is taken 3 times a day, 1 tablet 2 hours before meals. Children take the drug twice a day. |
| Movalis | Non-steroidal anti-inflammatory drug with analgesic effects. It is produced in yellow tablets with the company logo in a dosage of 7.5 and 15 mg. Used in therapy:
The total daily dose should not exceed 15 mg. |
For spasmodic pain
The antispasmodic group of analgesics relieves pain syndrome, dilates blood vessels and relaxes muscles. Medicines are needed for spasmodic menstrual and stomach pains. 
Among the large number of drugs are:
| A drug | Short description |
| Drotaverinum | Sold in tablets in cartons or jars of 25 or 50 pcs. Drotaverin is prescribed for the following conditions:
According to the instructions, the drug is taken 3 times a day, 1-2 tablets. |
| Sparex | The medicine is made in capsules, it affects the muscles of the gastric tract, it is applied 1 capsule 2 times a day before meals. |
| Spazmalgon | The product is produced in the form of a solution and tablets. Introduced 1 tablet 3 times a day after meals. The daily intake should not exceed 6 tablets, and the treatment lasts no more than 5 days. Dose increase and treatment schedule are prescribed by the doctor. |
With oncology
Oncology is closely related to pain, and only strong analgesics prescribed by a doctor can alleviate the patient's condition. 
For example:
| A drug | Short description |
| Ketanov | Tablets that allow you to relieve a variety of pains for a short time. Adults can take 10 to 20 mg 3-4 times daily depending on the theology of pain. When administered as a solution intramuscularly, the dose is up to 30 mg every 6 hours. The duration of treatment should not exceed 2 days. |
| Promedol | It is used as a solution for injection in a dosage of 1 ml to relieve pain after surgery and injuries. Adults are injected intramuscularly or intravenously at 30 or 50 mg. The maximum dose is up to 200 mg per day. Children over the age of 2 years are given parenteral doses of 3-10 mg. |
| Tramal | These are rectal suppositories prescribed for malignant neoplasms, heart attacks and injuries. A single dose for adults and older children, 50 mg orally, 100 mg - rectally or intramuscularly. For children under 14 years of age, the amount of drug intake is prescribed at the rate of 1-2 mg per 1 kg of body weight. The maximum daily dose should not exceed 400 mg. |
Precautions for taking pain medications
Taking any medications is associated with contraindications, which are indicated in the instructions. Pain relievers are no exception: just because they are available without a prescription doesn’t mean you can take them as often as you want.
The general rules for the use of pain medications are as follows:
Modern, powerful pain relievers that are available over the counter can relieve any pain. However, the human body is individual and uncontrolled prescription of medicines is fraught with complications, therefore, the agreement and control of the attending physician is mandatory.
Article formatting: Mila Friedan
Video about strong pain relievers
Painkillers that really help:
Analgesics are medications that can reduce or eliminate pain. Distinguish between narcotic and non-narcotic analgesics. Narcotic pain medications are rarely prescribed for certain indications. But we often resort to the use of non-narcotic analgesics if we are worried about pain.
Features of narcotic analgesics
Narcotic pain relievers inhibit pain-sensing structures in the central nervous system. This group of drugs is represented by opioid receptor agonists: morphine, promedol, codeine, fentanyl and others.
This group of drugs has a strong analgesic effect. However, narcotic analgesics affect not only the pain center, but also other parts of the central nervous system. So, these drugs inhibit the respiratory, cough, vasomotor, thermoregulatory centers. In addition, human behavior is disrupted due to a decrease in self-control. Addiction is formed to narcotic analgesics and, as a result, drug addiction.
Important! Given the wide range of side effects, as well as the risk of drug dependence, narcotic analgesics can only be used with a doctor's prescription.
Basically, the use of these drugs is resorted to in acute, life-threatening pain, as well as in pain syndrome against the background of inoperable malignant neoplasms.
Features of non-narcotic analgesics
Non-narcotic pain medications reduce the severity of pain and do not affect other structures of the nervous system. The mechanism of their action is based on a decrease in the excitability of the subcortical center of pain, an increase in the threshold of its pain sensitivity, inhibition of the synthesis of prostaglandins - inflammatory mediators. Thanks to this multicomponent action, non-narcotic analgesics have not only analgesic, but also anti-inflammatory, antipyretic effects.
Non-narcotic pain medications have a less pronounced analgesic effect in comparison with narcotic ones. However, their action is sufficient to relieve muscle pain, which we often encounter. The main advantage of non-narcotic pain medications is the absence of drug dependence on them. It is thanks to these properties that non-narcotic analgesics are widely used in medicine.
The use of non-narcotic analgesics may be accompanied by the development of side effects:
- Ulcerogenic action (ulceration of the mucous membrane of the stomach, duodenum);
- Nephro- and hepatotoxicity.
The main contraindications to the use of medicines from this drug group are peptic ulcer disease, blood coagulation disorders, hepatic and, pregnancy, lactation.
note : in the annotations to many anesthetic drugs, manufacturers indicate that joint use with other analgesics is contraindicated. This is fraught with undesirable clinical effects.
Popular pain relievers
The group of non-narcotic analgesics is represented by a wide variety of synthetic drugs. There are the following non-narcotic analgesics, depending on their origin:
- Salicylic acid derivatives:;
- Aniline derivatives:, phenacetin;
- Alkanoic acid derivatives:, diclofenac sodium;
- Pyrazolone derivatives: butadione, analgin;
- Anthranilic acid derivatives: mefenamic acid;
- Others: piroxicam, dimexide.
In addition, many pharmaceuticals now offer multi-drug combinations.
Analgin
This drug is known to everyone, it was synthesized in 1920. And although metamizole sodium (analgin) belongs to the group of NSAIDs, its anti-inflammatory and antipyretic effects are insignificant. But analgin has a pronounced analgesic effect.
Analgin is rapidly absorbed from the gastrointestinal tract, therefore the analgesic effect occurs quickly, although it does not last very long. Analgin is used for muscle, menstrual pain.
Important!A dangerous side effect of Analgin is the development of agranulocytosis. This is a pathological condition, which is characterized by a critical decrease in the level of leukocytes due to granulocytes and monocytes, as a result, the body's susceptibility to all kinds of infections increases. Because of this, Analgin was withdrawn from circulation in many countries. The risk of agranulocytosis when using Analgin is estimated at 0.2-2 cases per million.
Aspirin
Acetylsalicylic acid () is used not only as an analgesic, anti-inflammatory agent. The drug inhibits platelet aggregation, due to which it is used for the prevention of c. However, it is necessary to take into account the fact that with a violation of blood coagulation (in particular, with), bleeding may occur.
Aspirin is not recommended for use in children, especially if a viral infection is suspected. When using aspirin in this case, there is a risk of Reye's syndrome. The disease is characterized by rapidly progressive encephalopathy and fatty liver disease. Mortality in children with Reye's syndrome is approximately 20-30%.
It is also important to take into account that with prolonged, uncontrolled use of aspirin, ulceration of the mucous membrane of the stomach and intestines occurs, as well as gastric bleeding. To reduce the ulcerogenic effect, aspirin should be used after meals.
Ketanov
Ketanov (ketorolac) is a non-narcotic analgesic from the group of acetic acid derivatives. Ketanov is produced in the form of tablets, as well as a solution for intramuscular injection. After intramuscular injection of Ketanov's solution and after taking the pill, the analgesic effect is noted after half an hour and an hour, respectively. And the maximum effect is achieved after one to two hours.
Ketanov has a pronounced analgesic effect, exceeding the effect of other non-narcotic pain medications. Therefore, it is not surprising that many people with severe toothache, headache manage to get rid of unpleasant sensations only with the help of Ketanov.
In addition to the side effects traditional for non-narcotic analgesics, when using Ketanov, side effects from the central nervous system (drowsiness,) may occur. Therefore, when using Ketanov, it is recommended to avoid driving a car.
Dolaren
This is a combined preparation that also contains diclofenac sodium. Both of these medicinal substances enhance the action of each other. After taking Dolaren tablets, the maximum concentration of active ingredients is reached after an hour and a half. Many people report that Dolaren has a significant pain relieving effect when compared to other non-narcotic pain medications.
Dolaren is used for all kinds of diseases of the musculoskeletal system, as well as pain syndrome of any origin. The use of Dolaren will have to be abandoned if there is a hypersensitivity reaction to any NSAIDs, in the period after the operation, hepatic and ulcerative defects of the gastrointestinal tract, gastric bleeding. In addition, the drug is used with caution if a person has chronic and.
Nimesil
The active ingredient of the drug is nimesulide, an NSAID from the sulfonamide class. Nimesil is available in powder bags. The contents of the sachet must be dissolved in a glass with one hundred milliliters of water.