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Over-the-counter pain medicines: Use them safely

Person holding a glass of water and a pill in the other hand.

Tips for avoiding potential side effects from nonsteroidal anti-inflammatory drugs and acetaminophen.

To deal with life's minor aches and pains, you probably turn to over-the-counter (OTC) pain medications now and then. And that's OK—as long as you understand what you are taking and heed directions for safe use.

In general, OTC pain relievers are safe and effective. Most people can take them without any trouble, according to the Food and Drug Administration. But there are situations where you need to be cautious and check with your doctor beforehand.

Types of OTC pain medications

OTC pain relievers are medications that you can buy without a prescription. They can help to reduce fever and relieve pain caused by headaches, muscle aches and stiffness. They are also useful in treating minor pain from arthritis, earaches, back problems, the flu, a cold or a sore throat, according to the American Academy of Family Physicians (AAFP).

The two main types of OTC pain relievers are nonsteroidal anti-inflammatory drugs and acetaminophen.

Nonsteroidal anti-inflammatory drugs (NSAIDs). OTC NSAIDs include aspirin, with brand names like Bayer and St. Joseph; ibuprofen, with brand names like Advil and Motrin; and naproxen, with brand names like Aleve.

NSAIDs relieve pain, inflammation and fever by blocking natural substances called prostaglandins. According to the National Institute of Neurological Disorders and Stroke, prostaglandins are produced in response to injury. They cause inflammation and fever, and they allow pain receptors in the problem area to become more sensitive to pain.

Prostaglandins also are part of the body's temperature control system.

OTC NSAIDs may be helpful for temporary conditions such as sprains, strains and flare-ups of back pain. Prescription NSAIDs are available for the long-term treatment of chronic pain caused by conditions such as arthritis.

Cautions: You should always take NSAIDs with food or milk, because the most common side effects associated with the drugs are related to the stomach. NSAIDs can upset the stomach and increase the risk for stomach bleeding, as well as bruising. When taken for long periods, NSAIDs can cause kidney damage and make high blood pressure worse.

Acetaminophen. There are several types of OTC pain medicines that contain acetaminophen. Tylenol is one of the most common brand names. Some OTC products, such as Excedrin, contain both acetaminophen and NSAIDs.

Acetaminophen works by affecting the parts of your brain that receive pain messages and control body temperature. It is especially effective at reducing fever.

Cautions: Side effects with acetaminophen are rare. However, taking too much of it can damage your liver, especially if you drink alcohol, according to the AAFP.

You should not take acetaminophen if you have severe liver or kidney disease, if you have three or more drinks per day, or if you are already taking another product containing acetaminophen. Don't take more than 3,000 mg of acetaminophen per day.  

Follow directions for safe use

If you follow the directions for taking OTC pain medications, the drugs are generally safe. But if you mix them with other drugs without consulting your doctor or take them for prolonged periods, you could have problems.

Review the risks and benefits of an OTC medication with your doctor or pharmacist. If you've been taking a pain medication for longer than a week, you may want to explore other treatment options with your doctor.

Reviewed 5/30/2022

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