A Guide to Choosing Over the Counter Pain Relievers

When your head is pounding or your back is aching, there are dozens of over-the-counter analgesics, or pain relievers, available to make you feel better. But with so many brands, ingredients, indications, and side effects, how do you figure out which one to take? You don’t need a pharmacology degree to come up with the answer. A little basic understanding is all that is required to find the most effective – and safest – medication for battling your pain.

Over-the-counter, or OTC, pain relievers are most people’s first line of defense against pain. These analgesics are not addictive and are considered safe enough to use without a prescription. Still, OTC painkillers are not risk-free. They can have serious side effects when used incorrectly or over long periods of time. And self-medicating with OTC analgesics can mask symptoms or delay treatment of problems that require medical attention.

For most minor pain relief, the OTC drugs are about equally effective. But you may find that some work better than others in certain situations. Here are five of the most common ones:

1. Acetaminophen – Best known as the brand Tylenol, acetaminophen is the only OTC pain reliever that won’t irritate the stomach. Recent studies indicate that it may be the most effective fever treatment for both children and adults. Acetaminophen does not thin the blood, so it’s a safer choice for pregnant women (they should check with their doctor before taking any medication) and people with postsurgical pain.

2. Acetylsalicylic acid (ASA) – This is a time-tested drug that remains one of the least expensive, most dependable, and versatile medications. When combined with caffeine (in products like Anacin), it acts faster than any other pain reliever, making it the preferred choice of headache sufferers. Adults can safely use it for headache, fever, aches caused by colds, dental pain, and minor joint pain. Children can use lesser doses but should never take aspirin for fever or a viral illness, such as chicken pox; acetaminophen is safer. Aspirin can put them at risk for Reye’s syndrome, a rare but often fatal disorder. Because of aspirin’s blood-thinning properties, many doctors are recommending small daily doses (81 milligrams, or one-quarter of a standard aspirin tablet) for people at risk of heart attack and stroke. Promising studies also link regular doses with reduced risk of colon cancer.

3. Ibuprofen – Consider this a stronger version of aspirin. It is recommended for more acute pain, such as arthritis pain (under a doctor’s supervision) or sprains. Without the advice of a doctor, don’t take it longer than three to five days for swelling. Ibuprofen is the drug of choice for women with menstrual cramps.

4. Ketoprofen – Your doctor may recommend prescription NSAIDs (if the OTC drugs do not offer enough relief) and this drug is one of them. It is sold under brand names including Orudis. Ketoprofen is similar to Anaprox, and lasts up to 12 hours.

5. Naproxen sodium – This is another one of those prescription NSAIDs which your doctor may recommend. It is sold under the brand name Anaprox, and is similar to ibuprofen. One dose lasts 8 to 12 hours.

Although no one knows exactly why, pain relievers affect every person differently. You may need to experiment, following the package (and your doctor’s) instructions, to determine which pain reliever works best for you. A woman who doesn’t find ibuprofen helpful for menstrual pain might be pleasantly surprised by switching to naproxen sodium.

Side effects are a big factor when selecting a drug. All the NSAIDs – such as aspirin, ibuprofen, naproxen sodium, and ketoprofen – can cause stomach problems, especially in older people. It is, therefore, best to always check first with your doctor.