Pain killers with Dihydrocodeine These pain-killers are licensed for short term treatment acute, moderate pain which is not relieved by paracetamol, ibuprofen or aspirin alone. This medicine contains dihydrocodeine that can cause addiction if you take it continuously for more than 3 days. If you take this medicine for headaches for more than 3 days it can make them worse & cause chronic daily headache. If you need to take this medicine for longer than 3 days you should consult your doctor. These tablets should not be given to children under 12. How does Paramol work? The painkillers in Paramol tablets work in two different ways. Paracetamol is thought to work by reducing the production of prostaglandins in the brain & spinal cord. The body produces prostaglandins in response to injury & certain diseases. One of their effects is to sensitise nerve endings, causing pain. As paracetamol reduces the production of these nerve-sensitising prostaglandins, it is thought it may increase our pain threshold, so that although the cause of the pain remains, we don't feel it as much. Dihydrocodeine is a slightly stronger painkiller known as an opioid. Opioid painkillers work by mimicking the action of natural pain-reducing chemicals called endorphins that are produced in the brain & spinal cord. Codeine acts on the same opioid receptors as natural endorphins & this blocks the transmission of pain signals sent by the nerves to the brain. This means that even though the cause of the pain may remain, less pain is actually felt.