Are targeted painkillers a waste of money?

wavechange-
” painkillers on sale are counterfeit, but having learned that there are companies that substitute oregano for cheaper herbs, I begin to wonder what I am buying.”

I am not sure of the business nous of those criminals substituting oregano for cheaper herbs – perhaps its a Robin Hood thing. : )

” Until Which? has a regular TV programme I don’t think there is much chance of putting Nurofen out of business.” wavechange

Yikes don’t go putting ideas into their heads. I was watching Test.de appearing on a Stern/RLT programme where they were discussing the like of the Thermomix and the all-dancing Kenwood at around 1200Euro plus inferior machines. They were showing some of the tests and the final marks. If I understood German it would be even more useful.

Which? owns no testing facilities so it rather weakens the connection. I think there is also the problem that Which? is becoming more and more diffused and with commercial operations competing against advertisers commercial mainstream would be unlikely. For the same reasons the BBC is out. Launching an own Channel on Freeview or something simply not enough content – well apart from running the 1300? You Tube clips.

What I have in mind is something aimed at a more serious audience, like BBC2 documentaries, rather than Watchdog which is intended to appeal to the masses. You make a good point about the commercial involvement of Which? and BBC TV, but Which? campaigns do get publicised BBC TV.

I’d not like to see Which? getting into tv. The pressure of a good story would be too great for what should be an independent, balanced objective and fair-minded organisation. Coming up with regular “good” stories that would keep an audience would be beyond them without a large extra staff Goodness knows what it would all cost.

I’d like Which? to do its existing job better. It does not campaign in a neutral way in many cases, and it should. Maybe that is because it does not research in sufficient depth, or maybe it thinks it has to bias the campaign to gain public support.

I’d like to see in-depth testing, even if that means reducing the number of products. I’d like to see real help for consumers pursuing their rights. I’d like to see lobbying for more durable products, less throw-away stuff, longer guarantees, sensible paid-for warranties. This is where Which? used to be – or so it seemed. But what would tv do? By all means contribute to Watchdog when it has something worthwhile to say, but stay away from the tabloid sensationalist headline approach.

dieseltaylor says:
Which? owns no testing facilities …
============
You can’t be serious.

Then what are all those Execs getting HUGE pay packets for ”doing” with MY Dosh?.
—————-
Does anyone remember what the difference was between being a :
Member of the AA
and a
Member of the RAC
? ?
————-
Please, mr managing editor, this IS relevant to this discussion, just stay that e-shredding machine.

If the placebo effect is as strong as the intro suggests, it might not matter if you are buying chalk tablets 🙂 We pay for all the advertising that surrounds branded goods. When did you last see ibuprofen advertised? (just a guess!). Why should I fund the huge salaries of advertising agencies’ owners and employees?

”They seem to get stuck in my throat where they dissolve and I get a nasty taste in my mouth to go along with any pain.”
————-
Drink MUCH more fluid (e g water) and according to the NHS on-line advice you’ll get rid of that problem completely – and save £££

There are generic ibuprofen tablets that have a shiny coating, but as Josef says that answer is to drink plenty of water with them.

Water won’t wash them down once they are stuck, just dilute the taste.

Eating a piece of bread or other food will help pills go down.

Yep, food is the only thing that gets stuck tablets down my throat !!!

coat it in butter – works for getting tablets down the cat’s throat.

You should ideally take Ibuprofen with a glass of milk or with a meal, ie not on an empty stomach

Have a look at the related article on page 26 of the January magazine, Josef. It briefly explains the types of painkiller available over-the-counter and recommends that we ask the advice of the pharmacist.

+1

wavechange says:
I would like to see advertising checked for false claims before it is used. …
————–

As my maternal Grandmother used to say:
”JosefKafka”
‘coz that’s my name, NOT ‘Josef’
”Lies are halfway round the world before the TRUTH has got its boots on.”

The only way to stop Lies is to lock them in a room, and only let the Truth parts out – as you suggest.

If the companies have to pay to have their new adverts scrutinised then we would have less marketing and that could actually make products cheaper, since the consumer foots the bill for advertising.

It’s bad enough having dodgy advertising without finding reasons not to address the problem. 🙁

In my view it is not about the cost, it is the sheer impracticality. Imagine the huge numbers of people needed to scrutinise, investigate and check claims. An enormous bureaucracy of people who who would be much better off with more productive jobs.

Guilty until proven innocent is not something I would like to see in any walk of life.

The sooner we start the better then. We would not be having this discussion if companies behaved responsibly.

We should not tar all companies with the same brush. Many companies, like many other institutions, do behave responsibly. Some don’t.

We could make a start by focusing on the companies that have been the subject of complaints to the Advertising Standards Agency. We live in a sad society when even children learn not to trust advertising.

Dee my wife is also allergic to milk ,it is no laughing matter ,face swells up , throat restricts ,starts sweating profusely . She is allergic to vast amount of chemicals /food has been tested in hospital ,when she had kidney failure they refused to put dye through her as the allergic reaction could kill her and talking of injecting dye do you know there is cheap stuff and dear stuff ? .The cheap stuff makes you dizzy and unwell and has side-effects ,the dear stuff doesnt but is very expensive.

Humans’ ability to tolerate cows’ milk is only about 7 000 years old – and was one of THE significant developments in the rise of humans in the predominant role they now play on the planet.
”In order to digest milk, adult humans need to have a gene which produces an enzyme called lactase to break down lactose, one of the main sugars it contains.” BBC
But a surprizing 5% don’t have that gene.
.

Duncan,
Have you tried or had much luck getting milk-free medication?

I wrote to several pharmaceutical companies a few years back to see if there were milk/lactose-free versions of quite a few medications but didn’t have much luck as most of them use milk as the bulking agent.

Doctors were very reluctant to accept people could be allergic to milk until not that long ago but are still not good at prescribing milk-free drugs. Our local chemist is the most helpful in trying to find suitable brands.

Now if Which? were to lobby for milk-free drugs, there would be an awful lot of very grateful people out there.

Hi alfa ,our own rural GP and staff arent “into ” allergies hence giving me eyedrops that I had a very bad reaction to just to save money .Its probably down to his patients who being country people dont hold the same view as my wife and myself coming from a large city where my GP and hospital were more “up to scratch ” with modern medical practice . This is no offense against anybody living in the country its just a case of lack of informed info in the community as opposed to a large population where information retrieval by word of mouth gives rise to a larger knowledge base.

It’s important to distinguish between lactose intolerance and the much more serious condition of allergy to dairy products. The inability to digest milk sugar (lactose) is caused by having too little lactase (beta-galactosidase) and the symptoms are usually unpleasant rather than dangerous. Most adults with lactose deficiency get on fine with ‘lactose-free’ milk, which is ordinary milk treated with lactase to remove covert most (but not all) of the lactose into sugars (glucose and galactose) that those with lactose deficiency can cope with.

Lactose is commonly used as a filler in drugs, where the active component is very small – milligrams or micrograms. The amounts of lactose involved are not necessarily a problem for those who are lactose-intolerant. It would be better, in my view, if the pill producers chose a different filler.

I was replying to Duncan’s reference to being allergic as one tablet might not have that much effect depending on the person but several tablets all containing milk can give the patient mild anaphalaxia or worse.

When a person has to take several tablets, it is no fun having a permanent irritated throat on top of other problems when this could be avoided buy using a different bulking agent.

Sorry Alfa – I had not seen your comment when I posted mine.

In my case Dairy sets off IBS symptoms and pronto usually in around 15mins but the cramps are very painful and the end results even more so. Hence we have a camper for hol’s.
I had that same type of reaction to aspirin when I was about 15.
Three times that summer before anyone caught on what was causing the severe outbreaks. Just as well I was young I think.
In my case the symptom of swelling starts in the lower lip and spreads quickly. Eyes nearly close if one doesnt close all together.
Body in a rash that is worse than adult chicken pox to bear. Swole up everywhere
Itch everywhere, the very soles of my feet and even the unmentionable places
Terrible effect it had on my skin
I avoid all salicylate like the plague, makes me cringe the thought of it.
And like someone here I think is was wave wrote about the terribly tiny writing on remedies it would be very easy to make a mistake.
Have a search for a video, udderly amazing. Your wife will be interested in it.

Dee sorry about your symptoms I have spent a bit of my lifec studying people because I take an interest in people and their actions/motives . In this case over a long period I have found ,on average , speaking to a great many people and studying them that ,in the majority of cases those with severe allergies not attributable to a childhood of “overprotection ” from their mother so not becoming immune to germs was due to their racial heritage -IE- blond and red headed people were more likely to suffer from allergies of a permanent sort .This is a personal observation but the odds plied up in my favour over decades of checking .

Very observant. I never watched but I do people watch on other fronts.
Personally I am swarthy and my Mum and maternal Grandma had eyes black as coal and my daughter the same. Near everyone else here including me has versions of hazel eyes. Blood group suggests an Asian descent although how that arrives I do not know.
Terrible stomachs in the family if I was to name the thing that mist occurs but it may be brought on by anxiety in later life I’m noticing only people wont admit to that one. Mental illness/problems are still bit taboo it seems. But I have eye’s. I can see.
I would say Celtic in origin now I know that the north of Spain and Portugal has those roots along with quite a area here.
I have a Spanish connection many generations back that I know about anyhow but up until maybe 10 or 15 years ago i had not realised the extent of the Celts
My mothers family goes back via Scotland to Brittany as best I can research.
I’ll feel at home in any Celtic area even I dont know the language . Its not the area or the weather that makes me feel at ease its the people and the music and the in built “whatever it is”.
Better stop this rambling before we get accused again of something we didnt intend

DeeKay says:
Co-Codamol, Kapak is a popular option and dear knows how many other brands and in store own brands I’ve seen but as long as it says 30/500 they’ll work. mostly.
————
Co-Codamol = Codeine Phosphate Hemihydrate – Paracetamol
Once upon a time one could buy ‘Codeine’ tabs off the shelf – not anymore – 3-methylmorphine.
About the strongest off the shelf Co-Cod is 8/500 = not much use.
30/500 = a wonder pain reliever is (T M K) only on prescription, e g Solpadol (R)
.

banjo says:
The main articles talk…
————
A case for Unit pricing

Shops are restricted to selling 200 mg ibuprofen in packs of 16 tablets. A pharmacist can sell 400 mg tablets without prescription. The British National Formulary lists 600 and 800 mg tablets as prescription-only drugs.

342 mg ibuprofen lysine corresponds to 200 mg ibuprofen.

And you know why wavechange,dont you ? I cannot believe a website as responsible as Which has broached a medical subject without going deeply into it. I have worked in hospitals and seen the “evidence of this “”painkiller “” -paracetamol. Paracetamol is a hepatoxin -it DESTROYS liver cells ,even in small doses ,larger intake ,and I dont mean massive , results in liver failure . It is the most common cause of liver failure in the UK , if it is too late for an antidote drip AND a liver transplant then an EXTREMELY painful death occurs these are the down to earth medical facts . Have any of you watched somebody die of it ?? I have nearly the same as dying from acute alcohol poisoning. Your organs stop working you turn green/yellow you die moaning in agony over days ,why because for painkillers to work they need your body organs to intake the chemicals ,if those organs are dead then ? This doesnt make “nice ” reading but in a Convo like this it is vital to get this message across to the 1000,s of people who might commit suicide by downing those tablets –DONT !!!! many have and I have been in near tears with compassion for those dying this way. Just look at the UK suicide figures ,not something that the “authorities” want publicized.

Acetaminophen is a nasty constituent and what a lot don’t realise is that it can take up to six weeks to die from Paracetamol overdosing. And, as my learned friend says, it doesn’t actually take a lot of overdose to achieve that. The worst aspect of a paracetamol overdose is that you remain fully conscious throughout.

All drugs have side effects, of course, and Aspirin (Salicylic acid) has its own, but I do feel that insufficient people are educated enough about the truly dire side-effects of paracetamol over-consumption.

Duncan – Sorry but I don’t think Which? deserves the criticism. Joanna’s Conversation focuses on two main issues:

1. It’s not possible for an oral drug to target a particular site.
2. Generic drugs can cost a fraction of what the heavily advertised products do, the subject of earlier Convos.

There is a link to an article about unnecessary medicines and a brief mention of the placebo effect.

If you want to get a message across, it’s important to be brief and to the point.

Ibuprofen is used to treat pain, so I have no problem with the popular term ‘painkiller’ when writing for the general public. In my view it’s more important for the public to understand when to choose paracetamol or ibuprofen than knowing that the latter is best described as an anti-inflammatory drug. That’s not relevant to the introduction, but perhaps something that could be discussed in the comments.

The article is not about paracetamol, so why complicate it with a warning of the dangers of paracetamol. BTW, I’m surprised that paracetamol can be bought in a supermarket because of the danger you mention.

Whenever I get something wrong with me that doesn’t require a GP’s attention I speak to a pharmacist and I think people should be encouraged to do that more often rather than picking their way through the over-the-counter medicines that might or might not be suitable for their problem and could conflict with other medication [how many people read the multi-folded tiny-printed information sheets included in the box?]. Pharmacists are just as highly-trained as doctors and, importantly, know the limitations of treatments so can advise people to see their GP if complications might present or if something more specialised would be better for them. They will also be able to supply the appropriate generic drug and recommend the appropriate dosage.

As regards Duncan’s point about paracetamol poisoning: this has been curbed substantially by the new restrictions on unit sales and packaging in blister packs [instead loose in jars by the handful], nevertheless in the UK it remains the most common agent of intentional self-harm with over a hundred deaths a year due to this cause. Given the enormous quantities of paracetamol sold every year the death rate is exceptionally low, presumably because most people are not intent on killing themselves, act responsibly, follow the recommended dosage, and stop taking the tablets as soon as their pain is relieved or they realise it isn’t the right remedy for their condition.

It is terribly sad that some people wish to end it all with a drug overdose, and perhaps do not understand the pain they will endure, especially as they might have passed the point of being mentally receptive to any intervention. And since it is against the law to recommend alternative means of committing suicide this statistic will probably remain.

wavechange I had no intention of upsetting Joanna but dont you see where I am coming from I lived with people dying day to day when I worked in a hospital . To me this was real life it is very distressing to see somebody suffering so much from drugs that IMHO should be removed from the public use and replaced with another painkiller thats not so lethal . Would you give a Magnum pistol to a young person to play with ? thats how dangerous this drug is ,I am quite well aware that it was brought out to counteract the side -effects of aspirin which cause stomach bleeding to the extent of causing stomach ulcers and worse major hemorrhaging of the walls of the stomach allowing the contents to flow into other organs needing emergency surgery to save the patients life. Yes it helps in people with constricted blood flow /heart etc but this should not be hidden even if it were only a few deaths a year, each life is precious and public knowledge needs to be encouraged not hidden or in very small print somewhere.

Hi Duncan – I certainly do appreciate the problem of paracetamol poisoning, though I have no first hand experience. As John has said, measures have been taken to reduce the risk. I would prefer to see paracetamol and other pain relief drugs sold by a pharmacist who can check its suitability for the condition, compatibility with other medication, and recommend that the person should see their GP if they are concerned about long term use or possible misuse. On the other hand, paracetamol – if used sensibly – is a useful drug and avoids the problem of gastric irritation. It is certainly within the remit of Which? to make an input on marketing of drugs but not, I believe, matters of whether drugs are safe for sale and use. I would rather debate what we are invited to discuss and hope that it encourages more people to get involved in the debate. We can make input to the NHS and the public can now report problems via the ‘yellow card’ system.

This afternoon, I was reading a Guardian report “Banned and dangerous weapons found for sale on Amazon.co.uk”. Though I am tempted to post this on the current discussion about Amazon’s online food sales to alert people to what their favourite retailer gets up to, that would be off-topic and not very helpful.

I wouldnt disagree that caffeine helps with pain but I am a life -long tea drinker I found early on I am allergic to coffee ,what some tests showed that tea can help in cancer prevention . As cancer “runs ” in my family and relatives it must work as “touch wood” (my head ) I havent contracted it so far.

Thanks Beryl. It’s interesting to read that caffeine can both cause and cure headaches. I have drunk a lot of coffee since my student days and I don’t suffer any ill effects. I don’t think I’m alone but I do know others that are strongly affected by caffeine.

I see it as important that people are aware that some over-the-counter medicines contain caffeine, but if drinking coffee, tea and some soft drinks can provide caffeine, then maybe that’s a better way of giving the customer the choice.

Good point Wavechange, a less expensive standard generic pill swallowed down with a cup of caffeinated whatever you prefer could save you quite a bit.

Still haven’t worked out how you manage to sleep after drinking caffeinated coffee though!

I hope that inclusion of caffeine in medicines does not encourage their use to obtain the stimulatory effect.

My coffee intake is a habit rather than an dependence. I’ve drunk decaffeinated coffee for a week and not really noticed much difference. I’m not going to lose sleep about why drinking it does not keep me awake. 🙂

daver- I take it you are talking about general painkillers bought from a chemist shop by the public ? Otherwise in the cases of clinical diagnosis and the issue of medicines issued by a hospital or GP for certain clinical conditions I know for a fact there are many which “target ” certain organic illnesses in human beings this is one of the benefit of modern chemical discovery ,not only that many millions of people worldwide are kept alive in a relatively “pain-free ” condition due to the action of those drugs . I should know I am on ones at this very moment and if I wasnt my “raison etre ” for living would be very much diminished .

AS our government said it will put forward a– “more open and freer society” -aka- less government restriction on BB I reckon this is outside the remit of Which as its obviously political and “pressuring the government could be construed as putting forward an opposing political viewpoint (in their eyes ) ” . Unless somebody knows otherwise ?

Since the Advertising Standards Association is looking into complaints about Nurofen product marketing, there may be no need for further action by Which? Why not tell us if this is the case?

The ASA seems to do a good job, but companies are able to profit from false claims before being told to withdraw advertising.

Political issues need not be political if you adopt the approach that a task must be done irrespective of which party is in power. That’s my outlook.

What if research showed that there was a genuine placebo effect – that the same basic drug but sold as a target painkiller actually appeared to give better or quicker relief then the plain drug?
I remember seeing a program on tv (so it must be true) that rub-in painkillers like Voltarol sold as getting inside the body to the pain source do, in practice, do no such thing. Is there any evidence of their efficacy? If not should they not be withdrawn and their misleading (is it fraudulent) advertising banned?

The placebo effect is very well established and it is likely that users that believe in targeted products will find them more effective than exactly the same drugs that do not come with the claim. Nevertheless, it is ‘misleading advertising’ to suggest that pain relief can be targeted by an oral medicine.

Diclofenac is a more powerful non-steroidal anti-inflammatory than ibuprofen and is best avoided by many people, including those with stomach problems. Like many chemicals it will pass through the skin. I have long had my doubts how effective it would be to treat an arthritic knee, since the source of pain is well away from the skin. BNF states: “The evidence does not support the use of topical rubefacients in acute or chronic musculoskeletal pain.” There is no doubt that Voltarol gel and similar products offer topical treatment but the question here is whether they are effective. Unfortunately, it’s not a topic that Sense about Science has looked at.

“Nevertheless, it is ‘misleading advertising’ to suggest that pain relief can be targeted by an oral medicine.”. An interesting dilemma. If I believe a targeted drug helps my back ache – and if it does it better than the base drug – because of the way it is promoted is that bad? If, by banning the promotion, many people are no longer helped by the placebo effect, is that bad? I think I’d prefer to have my back ache helped. But do we put “principles” before outcome – does the end sometimes justify the means?

Cant agree wavechange and neither can the medical profession –misleading pain relief can be targeted . One of the pills I am on =SUMATRIPTAN – is a 5-HT receptor agonist .The SPECIFIC receptor subtypes it activates are present in the CRANIAL arteries and veins -it reduces the vascular inflammation associated with migraines. The SPECIFIC receptor subtype it activates is present in the Cranial and and Basilar arteries . Activation causes vasoconstriction of those dilated arteries also to decrease the activity of the TRIGEMINAL nerve – Now wavechange if that isnt targeted then I dont know what is !!! and there are 100,s like it . Its a wonder a doctor hasnt posted on this ,it is SO targeted that it has an ADVERSE effect on the rest of the body so cant under any thought process be classed as “general pain -killer “