Pain relievers are among the most common forms of medicine people take. Many are available without a prescription and can be bought almost anywhere. Easy access to pain relievers, though, does not mean you should take them casually. Be aware of common possible side effects and how to take them safely.
The two most common over-the-counter pain relievers are acetaminophen (such as Tylenol) and certain nonsteroidal anti-inflammatory drugs (NSAIDs). Nonprescription NSAIDs include aspirin, ibuprofen, and naproxen. Certain types of pain respond better to one pain reliever than another, and people often respond slightly differently to each drug.
Both types of over-the-counter (OTC) pain relievers can help reduce, relieve or manage discomfort caused by:
- Sore muscles
- Menstrual cramps
- Strep throat
- Sore throat
Should I take acetaminophen or an NSAID?
Acetaminophen: may be a good choice for:
- Common aches and pains
- Long-term arthritis management
Acetaminophen is also a good fever reducer.
NSAIDs. Ibuprofen or naproxen is often effective for:
- Menstrual cramps
- Sore muscles
- Pain related to inflammation. Along with relieving pain, NSAIDs can reduce inflammation (swelling and irritation).
How do they work?
Acetaminophen works on the part of the brain that receives pain messages and regulates body temperature.
NSAIDs are anti-inflammatory¿ medicines that work on pain and inflammation by reducing the production of prostaglandins. These are hormone-like substances that irritate nerve endings and help regulate body temperature.
Common drugs, common side effects
Pain relievers can cause serious side effects if you take them often, have certain medical conditions or take certain other medications.
Acetaminophen. High doses of acetaminophen can cause liver damage. If you have a liver problem or drink much alcohol with acetaminophen, even a standard dose can cause liver damage.
NSAIDs. Talk to your doctor before you take NSAIDs. Long-term NSAID use can cause stomach ulcers, gastrointestinal bleeding and kidney damage. NSAIDs can also affect high blood pressure. Talk to your doctor to make sure NSAIDs are safe, especially if you:
- Are over 60 years of age
- Have had stomach problems or ulcers
- Have liver or kidney disease
- Have a bleeding disorder
- Have high blood pressure
- Take medicine for high blood pressure
- Take aspirin to protect your heart or any sort of blood thinning drugs.
- Drink more than three alcoholic drinks each day
Children and aspirin don't mix
Do not give aspirin or products containing aspirin to children under age 19. Children who take aspirin may develop Reye's syndrome, a very serious and sometimes fatal illness
Interactions with other medications
Over-the-counter drugs can interact with other medications, including prescription drugs. This can increase the risk of side effects. For example, taking aspirin and a blood thinner like Coumadin (warfarin) could lead to dangerous bleeding.
Acetaminophen is an ingredient in many over-the-counter and prescription medicines, such as pain relievers and cough and cold remedies. Check the labels for acetaminophen. Don't take additional acetaminophen when you are taking these medicines. Taking more than the recommended dose does not provide additional pain relief. Combining products that contain acetaminophen could lead to overdose.
NSAIDs may interact with aspirin you take to protect your heart or with blood-thinning medications.
Tell your doctor about any over-the-counter drugs you are taking. They may contain the same pain reliever found in your prescription drugs. Never share your pain medication with anyone else. And keep all your medicines out of reach of children.
The bottom line
While pain relievers are readily available, there are many factors to consider before taking them or giving them to children. Talk to your doctor about which pain relievers are safest for you and your family before you take them. If you have questions, call your doctor or talk to the pharmacist to make sure you're taking the right pain reliever.
Created on 06/19/2007
Updated on 06/22/2010
- U.S. Food and Drug Administration. The best way to take your over-the-counter pain reliever? Seriously.
- American Chronic Pain Association. ACPA Consumer Guide to Pain Medication and Treatment
- Patient information collection. Chronic pain medicines. American Family Physician. 2004; 69(5): 1197-1198
- U.S. Food and Drug Administration. A guide to safe use of pain medicine.