Choosing from the dizzying array of over-the-counter (OTC) pain relievers can be enough to give you a headache. While they all may reduce fever and relieve minor pain from headache, arthritis, toothache, muscle aches, back pain and menstrual cramps, they work in different ways with different side effects. The pain reliever that’s best for you depends largely on which side effects you can tolerate as well as other factors. Pain relievers, or analgesics, generally fall into two categories, acetaminophen and anti-inflammatories.
Acetaminophen, the ingredient in Tylenol and Tempra, blocks the sensation of pain in the brain and spinal cord. Acetaminophen is found in hundreds of other prescription drugs and OTC medicines, such as antacids, sleep aids and cold and flu relievers.
Acetaminophen is a safe and effective pain reliever for headache, toothache, muscle aches and back pain. While acetaminophen helps bring down a fever, it does not reduce inflammation you may have with osteoarthritis or a sprained ankle.
Taking too much acetaminophen for too long can cause liver damage. If you regularly drink alcohol, avoid acetaminophen altogether.
This group of nonsteroidal anti-inflammatory drugs (NSAIDs) includes old-fashioned aspirin as well as ibuprofen (Advil, Motrin IB), naproxen sodium (Aleve) and ketoprofen (Orudis). Anti-inflammatories inhibit prostaglandins, body chemicals that irritate nerve endings, causing the sensation of pain.
Because NSAIDs combat inflammation, they can be more helpful than acetaminophen for conditions such as arthritis and sprains, where reducing inflammation helps relieve pain. Ibuprofen or naproxen sodium may work better than other relievers for menstrual cramps. Compared to steroid drugs like prednisone or cortisone, NSAIDs won’t cause osteoporosis, cataracts or thinning of the skin.
Side effects may include stomach irritation, gastrointestinal bleeding, dizziness, kidney and blood pressure problems or interference with blood pressure medication. People with liver disease, juvenile arthritis or rheumatic fever should avoid high doses of aspirin; children should not take aspirin at all. To reduce stomach upset, avoid alcohol and take anti-inflammatories with food or milk.
Ask your doctor what to use for pain, especially if you have a chronic condition or if you take other medication. If you’re on aspirin therapy, for example, you may need a different headache remedy. Take only the dose prescribed on the label for the allotted time. Read labels and package inserts carefully. Don’t take medicine for symptoms you don’t have or accidentally overdose by taking more than one medicine with the same ingredient. If symptoms don’t improve, see your doctor.