Use of OTC Pain Relievers in Selected Diseases and Conditions*
Disease State or Medical Condition
 Preferred Agent(s)
 Use with Caution
Allergy to aspirin, NSAIDs or tartrazine Acetaminophen (Panadol, Tempra, Tylenol), choline salicylate (Arthropan) or sodium salicylate Aspirin, ibuprofen, ketoprofen and naproxen sodium
Asthma or nasal polyps Acetaminophen, choline salicylate or sodium salicylate Aspirin, ibuprofen, ketoprofen and naproxen sodium
Bleeding disorder Acetaminophen or nonaspirin salicylates Aspirin, ibuprofen, ketoprofen and naproxen sodium
Congestive heart failure Acetaminophen Sodium salicylate, effervescent aspirin tablets with a high sodium content, and nonsalicylate NSAIDs
Dysmenorrhea Ibuprofen (Advil, Menadol, Motrin), ketoprofen (Orudis KT) or naproxensodium (Aleve) None
Hepatic impairment Acetaminophen† All NSAIDs
Hypertension Acetaminophen All NSAIDs
Lactation Acetaminophen Salicylates
Lithium therapy Acetaminophen or aspirin Ibuprofen, ketoprofen and naproxen sodium
Methotrexate therapy Acetaminophen All NSAIDs
Non-insulin-dependent diabetes mellitus managed with first-generation sulfonylureas Acetaminophen or ibuprofen Ketoprofen, naproxen sodium and salicylates
Oral anticoagulant therapy Acetaminophen‡ Aspirin, ibuprofen, ketoprofen and naproxen sodium
Peptic ulcer disease Acetaminophen All NSAIDs
Pregnancy Acetaminophen All NSAIDs
Renal impairment Acetaminophen All NSAIDs
Urticaria Acetaminophen Salicylates
Varicella or influenza ymptoms in a pediatric patient Acetaminophen or ibuprofen Salicylates

* -- Individuals with any of these conditions should talk with their family doctor before taking OTC pain relievers.

† Patients who have chronic liver disease that is not progressing may use acetaminophen.

‡ Patients taking anticoagulants who also take acetaminophen regularly or at higher doses should be monitored carefully.

NSAIDs = Nonsteroidal anti-inflammatory drugs.

Adapted with permission from APhA drug treatment protocols: self-care of self-limited pain. J Am Pharm Assoc. 1999;39:321-30.