Deciphering over-the-counter pain killers

Open the medicine cabinet in any family home and you’ll likely find an extensive assortment of pain relievers, fever reducers and anti-inflammatories. But which option is best for your symptoms? Chelsea Ferguson, PharmD, resident, Pharmacy, Parkview Regional Medical Center, helps us sort through the bottles on the shelves.

What are pain killers?
Pain killers are medications used to stop or reduce pain. There are many different type of pain killers, including non-prescription and prescription choices. The most common include Tylenol®, Advil®/Motrin®, Aleve®, Aspirin®, and other alternatives that can be purchased over the counter without a prescription from your doctor. Stronger pain medications for more severe pain are prescribed by a doctor.

How do the most common pain killers work?
Tylenol®, or acetaminophen, reduces pain and can lower a high temperature or fever, by acting centrally on the brain.

NSAIDs, such as Ibuprofen (Advil®, Motrin®), Naproxen (Aleve®), or Aspirin®, reduce pain, inflammation, and fever. They impair the production of prostaglandins in the body that are responsible for producing pain, fever, and inflammation. Aspirin has a stronger effect on the blood than the other NSAIDs. It inhibits small particles in the blood (platelets) from forming blood clots that could cause a heart attack or stroke.

How do I know which pain killer to choose?
Tylenol® is generally the best choice to treat a fever or a headache. It is also commonly used for other types of mild pain.

NSAIDs are generally the best choice to treat pain and inflammation (usually pain with redness, swelling, or heat), for example, arthritis or muscle pain. It can also be used to help lower a fever.

Aspirin® is generally the best choice for heart protection. Aspirin should be avoided with children 16 years and younger due to the risk for Reyes Syndrome, which is a serious medical condition.

What is the proper way to take pain killers?
Make sure you read the label to learn how much and how often you should take each medication. If you have any questions or are unsure, talk to your pharmacist or doctor to decide how much and how often to take the pain killer. There are many different products and combination products that include pain relievers, including cough, cold, and flu medications and other prescription medications. Understanding how much of a pain relief medication you are taking is important, as taking more than the recommended amount can be dangerous. The maximum dose of acetaminophen (Tylenol®) is 4000 mg per day.

These medications can be taken with or without food. If any of these medications cause you to have an upset stomach, taking them with food can help.

How long should I take pain killers?
Pain killers should be taken for the shortest time possible needed to help reduce/stop pain. If you are taking pain killers without relief or for a long duration of time, it is encouraged to talk with your doctor.

What are the possible side effects of pain killers?
Side effects are usually uncommon if pain killers are only taken for a short amount of time. Acetaminophen can cause liver damage, though this is rare. This can happen when taken in very high doses or in patients who regularly consume moderate to heavy amounts of alcohol. NSAIDs (Ibuprofen, Naproxen, Aspirin®) may cause upset stomach, constipation or diarrhea, dizziness, and headache. Occasionally, NSAIDs can cause stomach ulcers or bleeding or kidney problems and should generally be avoided in patients with similar stomach or kidney related conditions. Patients are encouraged to talk with their pharmacist or doctor about the side effects of each medication.

Can pain killers interact with my other medications?
Pain killers can interact with your other medications. It is important to ask a pharmacist or doctor before starting to take these new medications, even if for a short period of time. Pain killers may increase the risk of bleeding for those patients currently taking blood thinners. NSAIDs can also interact with your blood pressure medication.

What natural or homeopathic options are recommended for treating pain?
There are several alternatives for treating pain. Arnica, black cohosh, glucosamine, turmeric, and many others are available. These medications may work for you, however, some have unclear evidence for the benefit of treating pain. It is important to discuss these options with a pharmacist or doctor to determine if these options are right for you.



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