Which painkiller should I take?

[PaperBlueCornflower]

On Monday I was prescribed antibiotic/steroid ear spray.

This infection is causing a lot of discomfort in the lymph nodes scalp and jaw on one side of my head and I woke up at 4am in a lot of pain. My scalp, jaw and cheek feel very bruised (just on one side).

I had Ramipril prescribed recently so I asked the GP who said paracetamol or ibuprofen or naproxen would be ok short term but the pharmacist said I couldn't buy naproxen over the counter. I have a few cocodamol left over and also lemsip in the cupboard.

I'm not sure which would be best to take, if it was Friday I'd contact my GP again.

I'd appreciate suggestions and if there are any home remedies, other than a hot water bottle, I should try. (Garlic? Ginger? Hot Ribena?)

Naproxen is a very strong version of ibuprofen. If you're safe to take ibuprofen, take that, because it's an anti-inflammatory and the extreme pain will be because there's not much space for inflammation to go when it's ear pain. You can take paracetamol as well safely.

I would alternate paracetamol and ibuprofen. If you feel you need naproxen you’ll have to get it prescribed either by out of hours GP or wait until your surgery opens Monday.

Cocodamol I find good, but it can make you a bit constipated, which is a pain.

Thank you. Just the guidance I need.

I would alternate ibuprofen and codeine

Alternate paracetamol and ibuprofen in the first instance as codeine is much stronger, only use if you desperately feel you need to. Use a cold compressed on the side that's hurting. And I know it's difficult but rest up as much as you can! I hope you feel better very soon!

If the antibiotics haven’t started working by now you probably do need to see an out of hours Dr. You may need oral antibiotics.

Second this - the ear sprays are first line and if they are not working by now you want tablet antibiotics.

gp should help.

Pharmacist here.
Ibuprofen and naproxen are both NSAIDs and are roughly equivalent in effect. NSAIDs are generally not recommended with ramipril as both can cause acute kidney injury. Your GP presumably has sight of your blood tests and was happy enough with your kidney function to say it would be ok to use an NSAID short term (the Pharmacist won't have had access to that info so would take the more cautious approach of not combining them).

Paracetamol or co-codamol would be my 1st choice (co-codamol and lemsip both contain paracetamol so take care not to exceed the maximum paracetamol dose).

If you add in ibuprofen ensure you are well hydrated and use it at the lowest dose for the shortest period of time. Stop if you experience any of the symptoms mentioned https://kidneycareuk.org/kidney-disease-information/kidney-conditions/patient-info-acute-kidney-injury-aki/

Thank you all so much.