Over-the-Counter Pain Meds – Know the Difference

Over the counter Pain meds -- Know the Difference

By Jaclynn Thacker, MSN, RN FNP-C  •  

It’s time for enjoying outdoor activities – and with increased activity comes the possibility of sprains and pain from overdoing it a bit. And speaking of pain, regardless of the season, many people regularly experience chronic back or joint pain, or occasional headaches, toothaches or mild fever. 

What do these all have in common? Much of the time we treat these conditions with over-the-counter (OTC) nonprescription pain relief medicines like aspirin, acetaminophen (trademarked brand name Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).  All of these OTC medications also have variations that help promote sleep for people who experience pain (such as Advil PM, Tylenol PM and similar).

These OTC medications are generally available without a prescription. Physicians and providers often suggest them for mild conditions.

All of these pain relievers are common, but they are also all different. 

So, while all of these can provide welcome relief, it’s important to know what they are and what they do. Here’s a brief summary:

Aspirin (Bayer, Bufferin, Ecotrin, Anacin, generic)

Aspirin, called the “wonder drug” by one manufacturer because of its ability to both reduce pain and inflammation and to possibly lessen risk of heart disease, aspirin (acetylsalicylic acid) is widely used and is readily available nearly everywhere. Taken according to directions, aspirin reacts with your blood chemistry to reduce the effect of naturally occurring prostaglandins, which helps reduce pain, inflammation, and fever.

Aspirin also creates a blood-thinning effect. This, combined with its anti-inflammatory capacity, can be effective in reducing risks of heart issues. A drawback is that it also can cause uncomfortable stomach problems, heartburn, and other digestive issues.

Acetaminophen (Tylenol, generic)

Similar to aspirin, acetaminophen provides relief for mild-to-moderate pain (including moderate back pain) and fever reduction. A key difference is that it does not reduce inflammation (it is not an NSAID). This can limit its effectiveness for those suffering from a sprain injury or arthritis. Also, people should not drink alcohol while taking acetaminophen, as the combination can lead to severe liver damage. Acetaminophen is commonly included in branded remedies like Excedrin, Nyquil, Sudafed, Mucinex and Theraflu. Acetaminophen is also sometimes preferred for people with sensitive stomachs. It is generally regarded as safer for children than aspirin.

Ibuprofen (Advil, Motrin, generic)

Similar to aspirin, ibuprofen inhibits pain-transmitting and inflammatory-creating prostaglandins. Unlike acetaminophen (which works only in the brain), ibuprofen works throughout the body. Because of these qualities, ibuprofen (which, like aspirin, is an NSAID) is often recommended for arthritis and menstrual pain, as well as pain from sprains, headaches, back and muscle pain, and other common issues. It is generally less likely than aspirin to cause stomach upset.

Naproxen (Aleve, generic)

Like ibuprofen, naproxen is classified as a NSAID for its pain-reducing, anti-inflammatory effects. A key difference is that ibuprofen is generally faster-acting than naproxen, which makes it useful for dealing with acute pain. The effects of naproxen are longer-lasting than ibuprofen, which often makes the medication preferred for chronic pain and inflammatory conditions (like arthritis). But naproxen can cause stomach and related issues over time. 

Special note: because of research linking some NSAIDs to serious cardiovascular issues, many providers prefer acetaminophen as a first choice over ibuprofen, particularly in people older than 60. Also, all NSAIDs have been associated under certain conditions with kidney toxicity and allergic-type reactions. Anyone taking any OTC drug should be aware of potential side-effects.

While OTC medications can benefit us, it is important that they be taken according to directions. And always consult your provider if you’re experiencing chronic or lasting pain or inflammation. 

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