Over-the-counter (OTC) pain relievers are medicines that you can buy without a prescription from your doctor. Two main types of OTC pain relievers are available. One type is acetaminophen (brand name: Tylenol). The second type is nonsteroidal anti-inflammatory drugs (also called NSAIDs). NSAIDs include the following:
- Aspirin (2 brand names: Bayer, St. Joseph)
- Ibuprofen (2 brand names: Advil, Motrin)
- Naproxen (brand name: Aleve)
Some products contain both acetaminophen and aspirin (brand names: Excedrin Extra Strength, Excedrin Migraine, Vanquish).
How do pain relievers work?
Acetaminophen seems to relieve pain and reduce fever by working on the parts of the brain that receive pain messages and control the body’s temperature.
NSAIDs relieve pain and fever by reducing the level of hormone-like substances (called prostaglandins) that your body makes. These substances cause the feeling of pain by irritating your nerve endings. They also are part of the system that helps your body control its temperature.
What types of problems can OTC pain relievers help?
Acetaminophen and NSAIDs help to reduce fever and relieve pain caused by headaches, muscle aches, and stiffness. NSAIDs can also reduce inflammation (swelling). Acetaminophen does not reduce inflammation.
OTC pain relievers can be helpful in treating many types of pain, such as pain from arthritis, earaches, back pain, and pain after surgery. They can also treat pain from the flu (influenza) or a cold, sinusitis, strep throat, or a sore throat. Children who may have the flu or chickenpox should not take aspirin because they have a higher risk for developing a condition called Reye syndrome.
Acetaminophen can be a good choice for relieving headaches and other common aches and pains. It can be used safely on a long-term basis by most people for arthritis and other chronic painful conditions.
Ibuprofen is helpful for relieving menstrual cramps and pain from inflammation (such as muscle sprains). If ibuprofen doesn’t work for you, naproxen may be an option.
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Will an OTC pain reliever work as well as a prescription one?
For most people, OTC medicines are all that is needed to relieve pain or reduce fever. However, if an OTC medicine doesn’t help your pain or fever, it may be a sign you have a more serious problem or need a prescription medicine.
How do I safely take OTC pain relievers?
Read the directions on the drug facts label to learn how much medicine to take and how often to take it. If you have any questions about how much medicine to take, call your family doctor or pharmacist. Keep a record (1-page PDF) of which OTC medicines you are using and when you take them. If you need to go to the doctor, take this list with you.
Follow these tips to make sure you are taking the right amount of medicine:
- Take only the amount recommended on the medicine’s label. Don’t assume that more medicine will work better or quicker. Taking more than the recommended amount can be dangerous.
- If you are taking a prescription medicine, ask your doctor if it’s okay to also take an OTC pain reliever.
- Don’t use more than 1 OTC pain reliever at a time unless your doctor says it’s okay. They may have similar active ingredients that add up to be too much medicine.
- Check whether other OTC medicines you are taking contain acetaminophen. For example, many combination medicines for cold symptoms contain this active ingredient. Taking too much acetaminophen can cause health problems.
How can I safely store OTC pain relievers?
Store all medicines up and away, out of reach and sight of young children. Keeping medicines in a cool, dry place will help prevent them from becoming less effective before their expiration dates. Do not store medicines in bathrooms or bathroom cabinets, which are often hot and humid.
What are some common side effects of OTC pain relievers?
Side effects from OTC pain relievers are uncommon for healthy adults who only use pain relievers once in a while. If you have health problems or use OTC pain relievers often, talk with your family doctor.
Side effects with acetaminophen are rare. However, liver damage can occur if you take too much acetaminophen, or drink alcohol and take acetaminophen. For an adult, more than 3 grams of acetaminophen (6 extra-strength 500 mg tablets) a day is too much.
NSAIDs may cause upset stomach. They can also cause increased bruising or risk of bleeding in the stomach. When taken regularly, they may cause kidney damage. NSAIDs may also make high blood pressure worse.
Who shouldn’t take acetaminophen?
Do not take acetaminophen if you:
- Have severe kidney or liver disease
- Have 3 or more drinks that contain alcohol every day
- Are already taking another product containing acetaminophen
A note about infant acetaminophen
Starting in the summer of 2011, all manufacturers of infant acetaminophen, including Tylenol, changed the concentration (mg per mL) of acetaminophen in their medicines. This means that the instructions for giving these medicines to your child also have changed. The medicine you buy in the store may give different instructions than the medicine that you have at home in your medicine cabinet. Be sure to carefully read and follow the directions on the box or bottle of the product you are using. If you have questions, ask your family doctor or pharmacist.
Who shouldn’t take NSAIDs?
Talk with your doctor before you take an NSAID, especially aspirin, if you:
- Are allergic to aspirin or other pain relievers
- Have 3 or more drinks that contain alcohol every day
- Have bleeding in the stomach or intestines, or have peptic (stomach) ulcers
- Have liver or kidney disease
- Have heart disease
- Take blood-thinning medicine or have a bleeding disorder
Children and teenagers younger than 18 years of age who may have the flu or chickenpox should not take aspirin because of the risk of Reye syndrome, which is a serious illness that can lead to death.
Can OTC pain relievers cause problems with any other medicines I take?
NSAIDs can interact with blood pressure medicines. Someone who takes medicine for high blood pressure and also takes an NSAID may find that the blood pressure medicine does not work as well as it should.
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.