An Introduction to Over-the-Counter Pain Relief
By Kingman Regional Medical Center Staff
You wake up one morning with a minor ache. This pain is not a consistent issue so you decide to make a quick trip to the pharmacy to get an over-the-counter (OTC) pain reliever. Once you arrive, you realize how big the pain relief aisle is. How do you know which product to choose? Are there any differences between these products?
You might assume that items on grocery store shelves are safe to take, but there is no OTC pain reliever that is safe for everyone. The right OTC pain reliever for an individual can depend on several factors such as age, medical conditions, and other medication use. Read more to learn about the risks and benefits associated with some of the most common over-the-counter medications.
When used appropriately, acetaminophen is a safe OTC pain reliever. The recommended limit of acetaminophen within 24 hours is 3 grams (3,000 mg) which is nine regular strength (325 mg) tablets or six extra strength (500 mg) tablets taken 4-6 hours apart. Your liver breaks down Acetaminophen in your body. Taking too much can cause liver damage. This risk goes up even more when combined alcohol, so it is best to limit or abstain from alcohol consumption with Acetaminophen. However, within the recommended daily limit, Acetaminophen is an good choice for minor pain relief.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) like ibuprofen (Motrin®) or naproxen (Aleve®)
As the name suggests, NSAIDs help to relieve pain while reducing swelling. This makes NSAIDs an appropriate choice for muscle aches or joint pain. With correct dosage, NSAIDs can be used safely in children or adults for no more than a few days. Unfortunately, long-term use of NSAIDs comes with its own set of risks. Research has shown that long-time NSAID use increases risk of events such as heart attacks and strokes. Regular use of NSAIDs is also known to increase the risk of sores in the stomach lining that can cause stomach bleeds. These risks get higher as adults age, so responsible use of NSAIDs is important for people of all ages. Talk with your doctor if you plan to take an NSAID for more than a few days – especially if you have any issues with your liver or kidneys, as prolonged use could worsen these conditions.
Last but not least is aspirin. Another member of the NSAID family, aspirin relieves pain and reduce swelling like ibuprofen or naproxen. However, many doctors recommend aspirin to certain patients because of its blood-thinning abilities. For those at a higher risk of forming blood clots, aspirin can help reduce the chances of a clot. However, this does not necessarily make it a safer choice for pain relief. By thinning your blood to prevent clots, aspirin also puts you at increased risk for bleeding.
If you take aspirin to prevent clots, is it safe to take another OTC pain reliever? Using more than one pain reliever can compound the risks of each one. The combination of aspirin and NSAIDs can raise the risk of stomach bleeds even further. If you plan to use both aspirin and another NSAID like ibuprofen together, then be sure to take aspirin at least 2 hours before ibuprofen.
Additionally, children and teenagers who have recently recovered from a viral infection – like chicken pox or the flu – should avoid using aspirin. Aspirin can increase their risk of Reye’s Syndrome, a condition that affects the brain and liver and can be deadly.
The Bottom Line:
- Tell your healthcare providers about your pain.
Over-the-counter products may be a quick way to address your pain without a trip to the doctor, but continued use carries risks. If you are experiencing frequent or chronic pain, you may have an underlying health condition. Your doctor can help you better understand your pain and ensure that you address it in a safe and effective way.
- Beware of combination products.
Many products on the market include NSAIDs, acetaminophen, or aspirin. Some examples include Midol® for menstrual cramps (which contains acetaminophen) and Excedrin® for migraines (which contains both acetaminophen and aspirin). Take extra care when using combination products to ensure that you don’t take more than the safe daily limits. Avoid using other OTC pain relievers at the same time as combination products to reduce the risk of overdose.
- Read the labels.
Read the label to be sure that you take the correct dose and do not exceed the maximum daily dose. Be mindful of dosing guidelines – especially in liquid medications that you have to measure yourself. For children’s medication, check the safe age and weight ranges for proper dosing.
|Infants (less than 1 year old)||Follow the dosing directions on the packaging. Carefully measure liquid formulations.||Follow the dosing directions on the packaging. Carefully measure liquid formulations.||Risk of Reye’s Syndrome: Avoid use in infants unless told to do so by a doctor|
|Children & Adolescents (1 to 18 years old)||Follow the dosing directions on the packaging.||Follow the dosing directions on the packaging.||Risk of Reye’s Syndrome: Avoid using in children and teenagers recovering from viral infections|
|Adults (19 to 64 years old)||Do not exceed 3 grams in a 24 hour period. Avoid more than 1 gram per dose and wait 4-6 hours between doses. Avoid more than 1-2 alcoholic drinks while taking acetaminophen.||Follow the dosing directions on the packaging.||Follow the dosing directions on the packaging.|
|Older Adults (Age 65 years and older)||Do not exceed 3 grams in a 24 hour period. Avoid more than 1 gram per dose and wait 4-6 hours between doses. Avoid more than 1-2 alcoholic drinks while taking acetaminophen.||Increased risk of stomach bleeds, heart attack, and stroke: Helpful in swelling but long-term use can increase risk of events such as a heart attack or stroke.||Increased risk of bleeding: Use as directed by your doctor.|
|Adults with kidney issues such as kidney disease||No increased risk||Limit use. Check with your doctor or pharmacist if NSAIDs interact with medications you take.||Use as directed by your doctor.|
|Adults with liver issues such as cirrhosis||Safe to use in low doses. Do not take more than 2 grams in a 24-hour period||Avoid use when possible||Avoid use when possible|
*This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition