Painkillers and how they are taken

Painkillers are medicines to manage pain. They are also known as analgesics. There are many types available and different ways of taking them.

Painkillers are usually taken by mouth as a tablet or capsule. If you find swallowing difficult, you can often get them in liquid form or as pills that dissolve in water.

You may be given painkillers in other ways such as skin patches, gels, nasal sprays or suppositories. Buccal and sublingual medicines dissolve in the mouth and act quickly, so they’re often used for breakthrough pain. Injections and drips can also be used. If you need strong painkillers over a period of time, a small pump called a syringe driver is used, which releases a dose of painkiller at a constant rate.

Always tell your doctor or nurse if you have pain, or if your pain gets worse.

Painkillers for controlling cancer pain

There are many painkillers available to treat different types and levels of pain. Painkilling drugs are known as analgesics. Your medical team will aim to find the right combination of painkillers for you.

Some people with cancer have constant pain, so they need to take painkillers regularly to keep the pain under control.

If you are prescribed painkillers, it’s important to take them at regular intervals. This is to make sure the medicines are as effective as possible. Your medicines will be most effective if you follow the schedule.

It’s important not to let pain increase until it becomes severe. Tell your doctor or nurse if your pain gets worse. Severe pain can cause fear, anxiety and difficulty sleeping. These things can make the pain worse and more difficult to control.

Not everyone who has cancer pain has advanced cancer. But if your cancer is advanced, we have a video about pain control for people with advanced cancer that you may find helpful.


Ways of taking painkillers

Painkillers are mostly taken by mouth – either as tablets or capsules. For people who find it hard to swallow, many oral medicines are available as liquids and some can be dissolved in water. Sometimes, painkillers may be given in other ways:

Skin patches

These are stuck onto the skin. They are useful when your pain is under control. They only need to be changed every few days.

Gels

Some painkillers can be rubbed onto the skin to help relieve pain in one area.

Buccal and sublingual medicines

These enter the bloodstream through the tissues in the mouth, so they don’t have to be swallowed. They are usually used for controlling breakthrough pain, as they work quickly.

Nasal medicines

Some painkillers can be sprayed into the nose. These work best for breakthrough pain.

Suppositories

These are inserted into the back passage of your bottom (also known as the rectum).

Feeding tube

If you have a feeding tube such as a PEG (percutaneous endoscopic gastrostomy) or RIG (radiologically inserted gastrostomy), some liquid or soluble painkillers can be given through the tube.

Injection

Many painkillers can be given by injection, either into a muscle or more usually under the skin.

Infusion

Some painkillers can be given by infusion over a period of time. There are different ways of giving painkillers by infusion:

  • Subcutaneous infusion -This involves giving a continuous dose of a drug or drugs into a fine needle that is placed just under the skin. A small portable pump called syringe driver is used to give the drugs.
  • Intravenous infusion using a patient-controlled analgesia (PGA) - A PCA pump can be used to give pain relief after surgery. The pump has a button on a handset that you press to give yourself a set dose of a painkiller. If you need surgery, your doctors will give you more information about PCA.
  • Epidural and intrathecal analgesia.

These may be used to relieve pain after surgery. They are also used during labour, when a woman is giving birth. Sometimes, they can be used to help people with cancer pain. An anaesthetist will manage this type of pain control. Your doctors or an anaesthetist will tell you more about epidural or intrathecal analgesia if you need them.


Syringe drivers for giving pain control

Many strong painkillers (strong opioids) can be given by a syringe driver.

A syringe driver is a small, portable pump that can be used to give you a continuous dose of your painkiller and other medicines through a syringe. You may use one if you’re being sick or you can’t swallow. Your doctor or nurse will let you know if you need a syringe driver. 

A syringe driver is battery powered. The painkiller is put into the syringe, and the syringe is put into the driver. It is attached by a long tube to a fine needle or cannula that is placed just under the skin. A small dose of the drug is then released at a constant rate for as long as you need it. The syringe is usually changed every 24 hours by a nurse.

Syringe drivers are portable so you can move around as usual. They can clip onto a belt, or fit into a pocket, bag or bum bag. Or they can be placed in a specially designed holster (holder) that fits under your arm. Other medicines, such as anti-sickness medicines, can also be given through the syringe driver.

Some people worry that if they have advanced cancer and need a syringe driver, this could shorten their life. This isn’t true. A syringe driver is simply a different way of giving drugs at the dose you need to control your symptoms.