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Use paracetamol concurrently. The concurrent use of paracetamol with tramadol or codeine is more effective than tramadol or codeine alone.2 Co-prescribing of paracetamol is an effective and widely used strategy for reducing tramadol and codeine use thereby improving patient safety and providing pain relief as these Step 2 analgesics are withdrawn. Tramadol is associated with a decreased risk of respiratory depression and is therefore often preferred over codeine or dihydrocodeine in patients who are at increased risk of breathing difficulties, e.g. for musculoskeletal pain in a person with chronic obstructive pulmonary disease (COPD).2 Tramadol may also be preferred over codeine or dihydrocodeine in patients with a history of constipation or in those taking anticholinergic medicines. There is weak evidence that tramadol is effective in patients with neuropathic pain.
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We also asked parents about other things they wished their prescribing physician had done. While 43 percent didn’t express any concerns with the physician prescribing ADHD medication for their child, 29 percent said they wished the physician would “welcome their input about their child more than he/she currently does.” Twenty-six percent said they wished doctors would “provide information about any financial relationships he/she may have with companies that sell ADHD medications,” and 25 percent said they wished doctors would “discuss the long-term safety of prescription medications for my child.” Parents didn’t rate doctors well for managing their child’s medication. “Patients or families should call whenever they have questions about a medication,” Goldstein urges. He offers these additional tips: Always call the doctor with questions. Even if all is well, check in by phone two weeks after beginning medication and schedule a visit one month after for a follow-up. After that, return visits will depend on the success of the treatment and side effects. In general, children doing well can be seen every six months.
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If you experience mild to moderate pain, try to rest and take things easy while your chosen pain killer gets to work. Take your mind off things by reading, watching television, listening to music. Write down how you feel – researchers have found that writing about negative experiences seems to reduce pain perception. Rubbing the area or applying hot or cold packs can reduce pain by stimulating other nerve endings that block transmission of pain messages. Like all drugs, painkillers can have side effects. If you are not sure which analgesic is most likely to suit you, always seek advice from a pharmacist or doctor. Always read the information provided with your painkillers and never exceed the stated dose. If pain persists, or becomes worse, always seek medical advice – both to find out the cause, and to see if you need a stronger prescription-only treatment.
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