Q: There are so many choices out there for aches and pains. Which medicine is best for me?
When you have mild to moderate pain like a headache, sore muscles or aching joints there are 4 pain medicines you can buy without a prescription: aspirin, acetaminophen (Tylenol®), ibuprofen (Advil®), and naproxen (Aleve®). Which one should pick?
Aspirin is the oldest of these four options and is available in two strengths: low dose or “baby” aspirin which are 81mg each and the adult dose of 325mg, which is exactly 4 times the 81mg dose. Many Americans take one aspirin a day to prevent heart problems because of how it works as a blood thinner. If you take any prescription blood thinner medicine like Plavix®, warfarin (Coumadin®), or one of the newer ones advertised on the television, don’t take more aspirin for relief of your headache pain. Since aspirin can upset your stomach it’s best to take it with food or a full glass of water.
Whether sold as Tylenol® or by its generic name acetaminophen, Tylenol® is the most popular and common painkiller sold in America. Although it is safe enough for kids to take, Tylenol® has a dark side: taking too much acetaminophen is deadly to your liver. Being available in over 200 different non-prescription products the popularity of acetaminophen makes it dangerous because its so easy to get too much.
If you take a prescription pain medicine you may already be getting acetaminophen. Look for the abbreviations APAP or ACET on the prescription label, or ask your pharmacist. If you have liver disease, don’t take Tylenol® until you talk to your doctor about whether taking it is safe for you and how much you can safely take for pain.
The other two pain relievers available without a prescription are closely related to each other and also to aspirin. Ibuprofen and naproxen were originally only given as prescription medicines, but now they are available in non-prescription products in addition to their stronger prescription doses. Aspirin, naproxen and ibuprofen relieve muscle aches and swelling better than acetaminophen and belong to a group of medicines called NSAIDs, or non-steroidal anti-inflammatory drugs.
When taking ibuprofen, also known as Advil® or Motrin-IB®, or its close cousin, naproxen, sold as Aleve® be careful to take it with food to avoid stomach pain and bleeding. NSAID medicines can also damage your kidneys, especially if you have kidney problems or take it when you are dehydrated.
Taking too much of an NSAID is particularly dangerous because it can cause stomach bleeding and kidney failure. In addition to the non-prescription NSAID remedies there are several prescription NSAIDs commonly prescribed. Ask your pharmacist if you are already taking a prescription-strength NSAID and if you are, avoid taking the non-prescription versions.
7 Tips for Taking OTC (over-the-counter) Pain Relievers Safely:
- For aching muscles and swelling, ibuprofen or naproxen usually works better than acetaminophen. Some people get more relief with one or the other. Ask your pharmacist before taking ibuprofen or naproxen to make sure that you’re not already getting a prescription product doing the same thing.
- Avoid taking an NSAID if you already take a blood thinner. Taking 81mg of aspirin daily is ok, though. Ask your pharmacist if you aren’t sure if you are on a blood thinner medicine.
- Watch out for taking too much Tylenol®. Healthy adults can take up to 4 grams per day, or the equivalent of 8 tablets of extra-strength acetaminophen. Older adults are should limit their Tylenol® use to 3.1 grams daily, or 6 tablets of extra-strength Tylenol®. If you take a prescription pain reliever ask your pharmacist to find out if it has acetaminophen in it, and how much.
- If you take aspirin daily for your heart, talk to your doctor o pharmacist before taking it for pain relief. It’s safer to take Tylenol® or another NSAID like naproxen instead.
- You can take both acetaminophen and an NSAID for pain at the same time, as long as you don’t take more than is safe for you. Your pharmacist is a medication expert and can advise you as to which one is best for you.
- If you have kidney disease avoid taking ibuprofen or naproxen for mild to moderate pain, and make sure that you stay well hydrated when taking either one.
- If you have liver disease, ALWAYS check with your doctor before taking Tylenol® or acetaminophen.
