Author: Andreas Gill, medical editor
Last update:
December 03, 2020
Written according to the highest scientific standards and checked by experts
Non-opioid analgesics include common, over-the-counter pain relievers such as acetylsalicylic acid and paracetamol. They are divided into different groups, which differ in terms of their effects and side effects. Caution is advised in the case of long-term, regular intake and combination preparations.
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- Ibuprofen is a pain reliever from the class of non-opioid analgesics: its active ingredient is not based on a modification of the strong narcotic opium.
- © Sherry Yates
The non-opioid analgesics (pain relievers), to which most headache and rheumatoid drugs belong, have, in addition to their pain-relieving (analgesic) properties, also antipyretic (antipyretic) and mostly anti-inflammatory (anti-inflammatory) properties.
In contrast to opioids, non-opioid analgesics develop their analgesic effect in an indirect way: They mainly inhibit the formation of inflammatory substances in the peripheral tissue and in this way reduce the sensitivity of the pain sensors (nociceptors). The pain-relieving effect of non-opioid analgesics is weak to medium, so that they are sometimes used in combination with opioids.
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Non-steroidal anti-inflammatory drugs and paracetamol
The non-opioid analgesics are divided into different groups based on their chemical properties:
The first group (acidic antipyretic analgesics) are the so-called non-steroidal anti-inflammatory drugs (NSAIDs) (e.g. acetylsalicylic acid, diclofenac, ibuprofen). Its areas of application are in particular inflammatory pain as well as bone, soft tissue and intestinal pain.
Paracetamol belongs to the second group, which is mainly antipyretic and has no anti-inflammatory effect (non-acidic antipyretic analgesics). It is usually given for mild or colicky pain and fever.
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NSAIDs: watch out for side effects with pain relievers
However, NSAIDs in particular have the disadvantage that the therapy can be associated with side effects. Nausea and vomiting, but also bleeding or ulcers in the gastrointestinal tract and / or blood clotting disorders, for example, can result. Therefore, caution is advised, especially with regular, long-term use of these pain relievers. Patients with impaired kidney or liver function should completely avoid NSAIDs.
Selective COX-2 inhibitors have a more targeted effect
For this reason, the more selectively acting and therefore better tolerated cyclooxygenase-2 inhibitors (COX-2 inhibitors) were developed in the early 1990s. They are used, for example, in patients to whom the NSAIDs cannot be given (however, in the presence of some intestinal diseases, the COX-2 inhibitors must not be given either). The modern drugs are – depending on the preparation – approved for the treatment of age-related arthrosis (joint changes), inflammatory arthritis (joint inflammation), menstrual symptoms and pain after operations.
Different dosage forms
The non-opioid analgesics are available in different dosage forms: They are available as tablets, capsules, juice, suppositories and sometimes also as fast-acting, injectable solutions, so that the doctor can adapt the therapy individually.
Do not take uncontrolled non-opioid analgesics
With uncontrolled, frequent use of non-opioid analgesics there is a risk of developing a so-called drug-induced headache. And pain experts advise against mixed analgesic preparations that contain caffeine, for example, as these can promote drug dependence.
People with persistent pain should refrain from self-medication and consult a doctor who is knowledgeable about the treatment of pain disorders and can prescribe opioids or other medications.
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