What you need to know about pain relievers

Use caution when considering over-the-counter options.

Aug 30 2019 | 02:12 PM

Headache? Have an aspirin. Back hurts? How about some ibuprofen? Feeling feverish? Time for some acetaminophen.

Over-the-counter pain relievers are often the first thing we turn to when we're injured or under the weather, and for good reason. They can be extremely effective at reducing pain, fever, and inflammation.

But because they're in just about everyone's medicine cabinet and you don't need a prescription to buy them, it can be tempting to treat them a little too casually — taking too many, too frequently, or for the wrong reasons.

Your local drugstore features two main types of over-the-counter options. Acetaminophen, better known by the Tylenol brand name, is primarily a pain reliever and fever reducer. Ibuprofen (a.k.a. Advil) is in a class of drugs called nonsteroidal anti-inflammatory drugs, or NSAIDs, which can reduce swelling or inflammation and provide pain relief. Aspirin and naproxen also are NSAIDs.

So while a physician might recommend ibuprofen for a strained or sore muscle, acetaminophen might be a better option for a fever.

Side effects

But there are some potential downsides to NSAIDs.

Aspirin and ibuprofen can cause an upset stomach and even ulcers. For an elderly person or someone with GI issues such as a peptic ulcer or bleeding, acetaminophen is a safer option.

Aspirin has blood-thinning and anti-clotting qualities, which may help prevent clot-related strokes but can lead to bleeding. Before you have surgery, your doctor may tell you to stop taking aspirin products for a minimum of a week before. It's usually OK to take acetaminophen instead.

Aspirin has been linked to Reye's syndrome, a rare and potentially fatal condition that can occur in children after a viral infection, making acetaminophen the preferred option.

Another lesser-known side effect from NSAIDs is tinnitus, or ringing of the ears patients come in with ringing in the ears, we ask, 'Are you taking aspirin?' because it can do that," Russell says.

Acetaminophen and alcohol don't mix

While acetaminophen can be safer in some cases, it's not without potential hazards, particularly when combined with liquor, beer or wine. If you drink heavily, there is a potential to develop liver toxicity.

Pain relievers are in other medications, too

Acetaminophen and aspirin are included in a lot of over-the-counter medications. If you're not paying attention, you might not even realize you're taking a pain reliever.

So if you're already taking pain relievers on top of these medicines — which include NyQuil, Theraflu and Alka-Seltzer Plus — you may be getting too large a dose. A severe overdose can lead to organ damage.

Frequent use may signal a bigger health problem.

What's the right dosage for what ails you? Your best guide is the follow the guidelines on the container.

In general, the recommended maximum single dose for ibuprofen is 400 milligrams, and the maximum daily dose 1,200 milligrams.

For acetaminophen, the maximum single dose is 1,000 milligrams (or the equivalent of two extra-strength Tylenol). The maximum daily dose is 4,000 milligrams, although people with existing liver damage should take less.

Even if you're not exceeding the recommendation, reaching regularly into your medicine cabinet may mean it's time to seek medical advice regarding the source of your discomfort.

If you're taking repeated doses day after day, you should speak to your doctor.

Source: Rush Copley Medical Center: rush.edu