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Over-the-counter pain relievers

Over-the-counter (OTC) pain relievers can help relieve pain or lower a fever. Over-the-counter means you can buy these medicines without a prescription.

The most common types of over-the-counter pain medicines are acetaminophen and NSAIDs.

Alternative Names

Medications for pain non narcotic; Drugs for pain non-narcotic; Analgesics; Acetaminophen; NSAID; Non-steroidal anti-inflammatory drug; Pain medicine - over-the-counter; Pain medicine - OTC

Using over-the-counter pain relievers

Pain medicines are also called analgesics. Each kind of pain medicine has benefits and risks. Some types of pain respond better to one kind of medicine than to another kind. What takes away your pain might not work for someone else.

Taking these pain medicines before exercising is okay. But do not overdo the exercise just because you have taken the medicine.

For children, read label to learn how much medicine you can give to your child at one time and for the entire day. This is known as the dosage. Talk to your pharmacist or your child’s health care provider if you are not sure about the correct amount. Do not give children medicine that is meant for adults.

Other tips for taking pain medicines:

  • If you take pain relievers on most days, tell your doctor. You may need to be watched for side effects.
  • Do not take more than the amount recommended on the bottle or more than your health care provider tells you to take.
  • Read the warnings on the label before taking the medicine.
  • Store medicine safely and securely. Check the dates on medicine bottles to see when you should throw it away.

Acetaminophen

Acetaminophen is known as a non-aspirin pain reliever. It is not a non-steroidal anti-inflammatory drug (NSAID), which is described below.

  • Acetaminophen relieves fever and headaches, and other common aches and pains. It does not relieve inflammation.
  • This medicine does not cause as many stomach problems as other pain medicines do. It is also safer for children. Acetaminophen is often recommended for arthritis pain because it has fewer side effects than other pain medicines.
  • Examples of OTC brands of acetaminophen are Tylenol, Paracetamol, and Panadol.
  • Acetaminophen prescribed by a doctor is usually a stronger medicine. It is often combined with a narcotic ingredient.

       Precautions

  • Adults should not take more than 3 grams (3,000 mg) of acetaminophen in a single day. Large amounts can harm your liver. 3 grams is about the same as 6 extra strength pills or 9 regular pills.
  • If you are also taking pain medicine prescribed by your health care provider, talk to your health care provider or pharmacist before taking any OTC acetaminophen.
  • For children, follow package instructions for the maximum amount your child can have in a single day. Call your health care provider if you are not sure about the instructions.

NSAIDs

  • NSAIDs relieve fever and pain. They also reduce swelling from arthritis or a muscle sprain or strain.
  • When taken for a short time, no longer than 10 days, NSAIDs are safe for most people.
  • Some NSAIDs can be bought OTC, such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
  • Other NSAIDs are prescribed by your health care provider. These include celecoxib (Celebrex) and nabumetone (Relafen).

       Precautions

  • DO NOT give aspirin to children. Reye syndrome can occur when aspirin is used to treat children who have viral infections, such as chickenpox or the flu.

Talk to your health care provider or pharmacist before using any over-the-counter NSAID if you:

  • Have heart disease, high blood pressure, kidney disease, or stomach or digestive tract bleeding.
  • Take other medicines, especially blood thinners such as warfarin or clopidgrel .
  • Are taking NSAIDs prescribed by your health care provider, including celecoxib (Celebrex) or nabumetone (Relafen).
 

References

Cohen SP, Raja SR. Pain. In: Goldman L, eds. Goldman'sCecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 29.

Zhou YL, Principles of pain management. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 44.

Updated: 6/10/2013

Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles CA; Department of Surgery at Ashland Community Hospital, Ashland OR; Department of Surgery at Cheyenne Regional Medical Center, Cheyenne WY; Department of Anatomy at UCSF, San Francisco CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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