Not all over-the-counter pain relievers are created equally. When it comes to choosing an OTC pain reliever, Dr. Jeffrey Steinbauer, professor of Family and Community Medicine at Baylor College of Medicine, says you should read the label before reaching for the medication for relief.
“Over-the-counter medications are often thought to be ‘safe’; but sometimes this isn’t true.,” said Steinbauer.
One of most common adverse medication events is overdose of acetaminophen, the active ingredient in Tylenol, he said.
“Acetaminophen was so ‘safe and effective’ that is made its way into many different medications for pain, colds, flu, sinus, cough, and other medications,” Steinbauer said. “As a result, patients can overdose on acetaminophen without realizing they are taking so much of it. It’s also dangerous because an overdose can cause liver failure.”
Other over-the-counter pain relievers can be dangerous too, especially if they interact with prescribed medications.
“The classic example is taking aspirin or other non-steroidal anti-inflammatory drugs if you are taking blood thinners,” he said. He noted some sedating OTC medications can also interact with prescriptions causing even more sedation.
Overall, if you have questions about the safety, dangers and interactions of over the counter medications, you can:
- Ask your pharmacist
- Ask your physician
- Check on the reliable health websites for information on safety and interactions
Steinbauer says if you are in doubt don’t risk taking something OTC that might make your illness worse or cause new problems.
Over-the-counter pain relievers
To use the sharing features on this page, please enable JavaScript.Over-the-counter (OTC) pain relievers can help relieve pain or lower a fever. Over-the-counter means you can buy these medicines without a prescription.
The most common types of OTC pain medicines are acetaminophen, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs).
Information
Pain medicines are also called analgesics. Each kind of pain medicine has benefits and risks. Some types of pain respond better to one kind of medicine than to another kind. What takes away your pain might not work for someone else.
Taking pain medicines before exercising is OK. But do not overdo the exercise just because you have taken the medicine.
Read labels to learn how much medicine you can give your child at one time and during the whole day. This is known as the dosage. Talk to your pharmacist or your child's health care provider if you are not sure about the correct amount. Do not give children medicine that is meant for adults.
Other tips for taking pain medicines:
- If you take pain relievers on most days, tell your provider. You may need to be watched for side effects.
- Do not take more than the amount recommended on the container or more than your provider tells you to take.
- Read the warnings on the label before taking the medicine.
- Store medicine safely and securely. Check the dates on medicine containers to see when you should throw them away.
ACETAMINOPHEN
Acetaminophen (Tylenol) is known as a non-aspirin pain reliever. It is NOT an NSAID, which is described below.
- Acetaminophen relieves fever and headaches, and other common aches and pains. It does not relieve inflammation.
- This medicine does not cause as many stomach problems as other pain medicines do. It is also safer for children. Acetaminophen is often recommended for arthritis pain because it has fewer side effects than other pain medicines.
- Examples of OTC brands of acetaminophen are Tylenol, Paracetamol, and Panadol.
- Acetaminophen prescribed by a doctor is usually a stronger medicine. It is often combined with a narcotic ingredient.
PRECAUTIONS
- Adults should not take more than 3 grams (3,000 mg) of acetaminophen in a single day. Large amounts can harm your liver. Remember that 3 grams is about the same as 6 extra-strength pills or 9 regular pills.
- People with liver disease should usually not take more than 2 grams (2,000 mg) of acetaminophen in a single day. Check with your health care provider for guidance on what is safe for you.
- If you are also taking pain medicine prescribed by your provider, talk to your provider or pharmacist before taking any OTC acetaminophen.
- For children, follow package instructions for the maximum amount your child can have in a single day. Call your child's provider if you are not sure about the instructions.
ASPIRIN and NSAIDS
- Aspirin and NSAIDs relieve fever and pain. They also reduce swelling from arthritis or a muscle sprain or strain.
- When taken for a short time (no longer than 10 days), aspirin and NSAIDs are safe for most people.
- Children under age 18 years should not take aspirin due to a risk for Reye syndrome.
- Some NSAIDs can be bought over the counter, such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
- Other NSAIDs are prescribed by your provider.
PRECAUTIONS
- DO NOT give aspirin to children under 18 years of age. Reye syndrome can occur when aspirin is used to treat children who have viral infections, such as chickenpox or the flu.
Talk to your provider or pharmacist before using aspirin or any over-the-counter NSAID if you:
- Have heart disease, high blood pressure, kidney disease, or stomach or digestive tract bleeding.
- Take other medicines, especially blood thinners such as warfarin (Coumadin),clopidogrel (Plavix), apixiban (Eliquis), dabigatran (Pradaxa), or rivaroxaban (Xarelto).
- Are taking NSAIDs prescribed by your provider, including celecoxib (Celebrex) or nabumetone (Relafen).
Alternative Names
Medicines for pain non-narcotic; Drugs for pain non-narcotic; Analgesics; Acetaminophen; NSAID; Nonsteroidal anti-inflammatory drug; Pain medicine - over-the-counter; Pain medicine - OTC
Images
- Pain medications
References
Aronson JK. Non-steroidal anti-inflammatory drugs (NSAIDs). In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:236-272.
Dinakar P. Pain management. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 52.
House SA. Pain. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2021. Philadelphia, PA: Elsevier 2021:32-39.
Review Date 10/11/2020
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.