Danielle Stowasser Pain Relief Interview

Danielle Stowasser Pain Relief Interview.htm

What's In Your Pain Relief Medicine?
New research from NPS MedicineWise has revealed some confusion regarding the active ingredients contained in many common over-the-counter pain relief medicines.

Of the 502 respondents who had taken an over-the-counter or prescription medicine in the past three months, 80% said they had taken an OTC analgesic.

When respondents were asked to name the active ingredient in the analgesic they had taken, there was notable confusion. For those who had taken Nurofen, only 43% of respondents correctly named ibuprofen as the active ingredient. 39% incorrectly stated paracetamol and a further 9% said Panadol was the active ingredient.

Results were slightly higher for those who had taken Panadol, with 61% of respondents' correctly naming paracetamol as the active ingredient. Incorrect responses given by 22% included aspirin or ibuprofen or the brand name Panadol. Just under half of respondents correctly named paracetamol as the active ingredient in Panamax.

Encouragingly, 80% of respondents correctly named paracetamol and codeine as the active ingredients in the combination pain relief medicine Panadeine.

NPS clinical adviser Dr Danielle Stowasser said knowing the active ingredient in your medicine was an important step to being medicinewise and would help people avoid making mistakes, for example accidentally double dosing.

'There are around 350 different pain relief medicines available over-the-counter in Australia, marketed under a variety of names, branding and packaging. Having so many choices can be confusing, which is why identifying the active ingredient can help you find a pain relief medicine which is safe and effective for managing your pain."

The active ingredient is the ingredient in pain medicines which gives you the therapeutic effect and is printed on the medicine label or packaging. The most common active ingredients in pain relief medicines are paracetamol, ibuprofen or aspirin. Combination pain relievers containing paracetamol or ibuprofen with codeine are also available but only in pharmacies.

Dr Stowasser said it's important to always read the medicine label and follow the instructions carefully.
'Just because something can be bought over-the-counter, doesn't mean it doesn't have strong effects or even side-effects at what is considered normal doses. Never take more than the recommended dose of a pain relief medicine - it will not give you greater relief and could be harmful to your health."
'Sometimes people accidentally take a double dose without even realising it, such as taking cold and flu tablets and Lemsip at the same time. Both of these contain the active ingredient paracetamol and doubling up like this can cause damage to your liver," Dr Stowasser said.
'If you are taking other medicines, always ask your doctor or pharmacist to check for potential interactions and advise which pain reliever you can use safely and effectively."

The NPS -Be medicinewise – Managing Pain' campaign has a variety of tools, information and tips to help Australians manage their pain safely and effectively.
For further information visit www.nps.org.au/managingpain

Interview with Dr Danielle Stowasser

Question: Can you talk about the importance of the -Be medicinewise – Managing Pain' campaign?

Dr Danielle Stowasser: What we know is about 70% of Australians have had a medicine in the last three months and that increases as you get older. Once you get to the over 65 group it goes up to about 90% of people who have had a medicine in the last week. We use a lot of medicine; about 15 million Australians are on a medicine at any point in time, what the issue with that is that people don't realise that these medicines have strong effects or don't understand what a -medicine' means. People don't realise that medicines include: over-the-counter medicines, herbal preparations from your local naturopath or health food store (although they might be natural they do have strong effects) and medicines are not just what you may take, they can be eye-drops and creams - a lot of them are actually systemically absorbed into the body.

Consumers are not recognising or telling their health care providers about their medication which potentially leads to interaction between this medicine shouldn't be given to this medicine or what we call a contra-indication whereas a medicine might actually impact a disease or condition you have or cause a disease or condition. If the health care professional does not have all that information then they are not making decisions or providing the consumer with information to inform their disease management.

What we are saying is:
First of all know it is a medicine and secondly know what the active ingredient is.

The concept is for people to realise that medicines have two names, they have an active ingredient name which is the chemical which is causing the affect in the medicine and the other thing is the brand name. It is much the same as tomato sauce which contains tomatoes which is what gives the sauce the flavours and the brand might be Heinz or Rosella but it is all tomato sauce.


Question: Can you talk about the respondents who could not name the active ingredient in their pain relief medication?

Dr Danielle Stowasser: Panadole and Panamax are brands and the main ingredient is called paracetamol. What is more worrying is when you look at things like ibuprofen, which is an active ingredient contained in Nurofen and Heron Blue and what we found in our survey of 502 is that of the people who had taken Nurofen brand in the last three months only 43% knew it contained ibuprofen and in fact 39% thought that it contained paracetamol.


Question: Which means they are missing vital information necessary when taking ibuprofen, such as the importance of taking ibuprofen with food.

Dr Danielle Stowasser: That's right ibuprofen acts on your kidneys, it acts on your heart and interacts with numerous drugs. If a consumer is not recognising that it contains a totally different active ingredient they may end up double dosing such as taking Panadole and Panamax and double dosing on paracetamol. Or consumers may be having an adverse event that they don't realise because the active ingredient interacts with other medicines or with their condition.

We are saying to people:
1.Know it's a medicine
2.Know it's active ingredient
3.Ask the right questions.


Question: What are the -right questions'?
Dr Danielle Stowasser: By that we are not implying there are right or wrong questions but that you need to ask a number of questions to get the correct information to help you. It is about saying to people these are the range of things that you should know and here are the top five questions you should ask. A lot of this campaign is about the top five questions you should ask.

To view the questions, please see: www.nps.org.au/managingpain

The questions are to make consumers more informed and health literate. The top five questions are for different situations such as:
if you are thinking of taking a pain medicine,
if you are thinking of starting a new medicine,
if you are having a review of your medicine,
if you have a child in pain.

In each of those different situations the website explains what the top five questions you should ask are.


Question: Can you talk about the importance of clearing out our medicine cabinets?

Dr Danielle Stowasser: All medicines, by law have to have an expiry date on them. The Therapeutic Goods Administration works with the pharmaceutical manufactures to work out the life span of the active ingredient in delivering therapeutic effect. Once the medicine gets to that end of time it doesn't necessarily mean the medicine is decomposing but it will reduce effectiveness; the other thing is that over a period of time the medicine might degrade and actually be toxic. It is similar to your milk, you wouldn't use the milk pass the expiry date, it is still milk but it may have turned into sour cream and therefore it is not good for you. If the medicine is in the cupboard it is a temptation to use it when it is not the best thing.

The other thing with eye drops that most people don't commonly understand is that there is a preservative in eye drops and if you go beyond that point in time it would be like putting off milk into your eye. You wouldn't put off milk into your eyes or even your mouth but some are willing to say it doesn't matter if it's over the time I can still use my eye drops.

The other thing that people do with antibiotics is they think that if a certain antibiotics was effective last time, I'll keep it, because it might be effective this time but in fact you might have a totally different condition or the bacteria that you have may be resistant to that antibiotic.

There is a reason why you should not store or stock medicines over a period of time, you need to look at removing them.

We recommend taking the medication back to your community or hospital pharmacy because you shouldn't flush it down the toilet or put it in rubbish bins because it could be found by children or dogs and also it is not good for the environment.

Interview by Brooke Hunter

Independent, evidence-based and not-for-profit, NPS enables better decisions about medicines and medical tests. NPS is funded by the Australian Government Department of Health and Ageing.