How are pain relievers made

Painless: How headache relievers work

As common as they are: How tension headaches and migraines develop is still not fully understood. Experts suspect that pressure on the meninges and the nerve tracts running through them is responsible for the pain. During a migraine attack, on the other hand, the blood vessels in the area of ​​the meninges widen and become inflamed.

Why we feel pain - and how pain killers get rid of it

No matter what the cause of the headache is - certain cells are always excited in the affected body region, which pass on the pain stimulus. These cells are called pain receptors or nociceptors - from the Latin "nocere" for "harm". They convert the excitation into an electrical impulse and send it via the spinal cord to the brain, which recognizes that the head hurts. Actually a very useful thing. We know this way: Warning, here is a problem - you already or do something about it.

So that the pain receptors can pass on the information about the pain stimulus, they need a special messenger substance: the prostaglandins. When we injure ourselves or our tissue is inflamed, our body produces more of this messenger substance. Prostaglandins make the pain receptors nearby sensitive so that they become active and send the information to the brain.

In order to be able to produce prostaglandins, our body uses a special enzyme, the "COX" enzyme (COX is the abbreviation for the somewhat complicated name of the enzyme: cyclooxygenase).

Many of the over-the-counter drugs, especially ASA, ibuprofen, diclofenac and naproxen, target this enzyme. These drugs block the way the COX enzyme works. As a result, the body can produce fewer prostaglandins. The pain receptors are less aroused and no longer send signals to the brain. The pain disappears.

How the active ingredient gets to the site of action

If you take drugs such as aspirin or ibuprofen, the tablet is first dissolved in the stomach and the active ingredient is passed on to the intestine. From there it enters the bloodstream and travels through the whole body to the point where there are more prostaglandins. Like sand in a gear, the active ingredient now blocks the COX enzymes so that prostaglandin formation stops - the pain subsides.

Prostaglandins also protect the stomach and kidneys

Prostaglandins also have other roles in the body. For example, they regulate the production of gastric acid and thus protect the gastric mucosa. They cause the platelets to clump together faster when we injure ourselves, and thereby help the bleeding go away quickly. They also play an important role in the physiological function of the kidneys. If their production is blocked by drugs, undesirable side effects on the stomach and kidneys can occur.

Paracetamol works differently

The active ingredient paracetamol plays a special role: it also suppresses the formation of prostaglandins. At the same time, however, it also seems to work in the brain, where it blocks the transmission of pain between nerve cells. Paracetamol also affects a part of the nervous system that has calming and analgesic effects, the so-called endocannabinoid system. Paracetamol is considered to be more stomach-friendly than ASA and ibuprofen, but it puts a strain on the liver.

Is it also faster?

Before a headache tablet gets into the bloodstream and reaches the painful area, it first passes through the stomach, intestines, heart and lungs. Therefore, it takes some time - usually up to 30 minutes - for the pain reliever to kick in. If your stomach is empty, the active ingredient theoretically reaches the intestines faster and from there into the blood. Medicines like ASA and ibuprofen can irritate the stomach and cause heartburn and nausea. It is more gentle on the stomach to take the tablet with or shortly after a meal.

Studies show that caffeine can increase the effects of pain relievers and accelerate the onset of action. Combination preparations, which you can also obtain over the counter at the pharmacy, use this effect. Instead, drinking a cup of coffee with the pain reliever is not recommended, as it can irritate the stomach. Always take the pain reliever as directed in the package insert with a glass of water.

However, many experts recommend avoiding combination products, as some of the active ingredients they contain may be underdosed. This can lead to the fact that you take more tablets than necessary. From a medical point of view, it is therefore advisable to take the individual active ingredients in the correct dosage.

Unpredictable: painkillers and alcohol

Alcohol and medication do not belong together, because alcohol can increase or weaken the effects of drugs. In addition, alcohol also irritates the stomach and can increase the side effects of ASA and Co. Since pain relievers stay in the body for eight to ten hours, a longer break from alcohol is advisable. It is particularly important not to use alcohol when taking paracetamol, as both substances are broken down by the liver. Therefore, paracetamol is not suitable for the treatment of hangover headaches.

How do triptans work?

In the case of a migraine, triptans are also effective against the pain. A migraine attack is triggered by the widening of the blood vessels in the brain. Triptans dock on certain serotonin receptors that influence the contraction of the blood vessels. This causes the cerebral vessels to narrow again. Triptans also inhibit the release of messenger substances that promote inflammation and the transmission of pain in the brain. So triptans can relieve pain as well as nausea and sensitivity to light. It is best to speak to your doctor or health care professional to determine whether this medication is right for you.