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Taking Over-the-counter (OTC) Pain Relievers

At first glance, visiting the pain-reliever section of your drugstore might just give you a headache--if you don't already have one. You'll find the shelves crowded with scores of products to choose from.

Choosing the best one, however, may not be the most important thing to be concerned about. Rather, the dilemma is whether to take something for the pain or to see a doctor.

For mild aches and pains

Headache, muscle pain, joint pain, fever, some sore throats, and menstrual cramps can be effectively treated with over-the-counter (OTC) pain relievers.

If the pain is severe or lasts for more than five days, the best advice is to see your health care provider. That advice also applies if the pain feels different than is typical for you, if it worsens, if the OTC drugs aren't working, or if you have other symptoms, like blurred vision or lightheadedness.

To treat pain, many people, however, start with pain relievers in their medicine cabinet.

Down to the basics

Although OTC pain relievers make all kinds of claims, may be packaged differently, and often include additional ingredients to treat other symptoms (such as upset stomach or a cold), just about all of them contain one of several chemicals: aspirin, acetaminophen, naproxen, ketoprofen or ibuprofen. All of these reduce fever, as well as pain. Aspirin, naproxen, ketoprofen, and ibuprofen also reduce inflammation and are called nonsteroidal anti-inflammatory drugs (NSAIDs). Many companies make OTC pain relievers that contain the same chemicals as brand name medicines and are just as effective. Read the bottle or package to see what the active ingredient is.

What should you take for different kinds of pain? It depends.  Aspirin and NSAIDS work the same. Take what has worked for you in the past unless your medical health has changed. Your doctor or pharmacist can help you make the choice if you are not sure.

Take precautions

NSAIDs can cause gastrointestinal bleeding and stomach upset, but taking them with food can help relieve the upset. They should not be taken by people on blood thinners or with kidney disease, ulcers or bleeding disorders, or those who are allergic to aspirin. People with asthma should be cautious when taking aspirin or NSAIDs, because in some people, these medications may bring on an acute asthmatic attack. NSAIDs may not be appropriate for people with high blood pressure and they should talk to their health care providers before taking NSAIDs. Elderly adults should especially use caution when taking NSAIDs. Children should not take aspirin because of the risk for Reye's syndrome.

Long-term use of NSAIDS should be avoided unless you are being monitored by  your health care provider.

Rarely, side effects causing liver damage have occurred even in people taking acetaminophen according to directions. Overdose and long-term or excessive use of acetaminophen, combined with alcohol use can damage the liver.

Be aware that these pain relievers are sometimes included as ingredients in other OTC medications. They may also be included as ingredients in other prescription medications. If you're not vigilant, you may be taking more than the recommended daily dosage of an ingredient you didn't realize you were taking. 

Any of these pain relievers may interact with prescription medicines and/or other OTC drugs. The FDA recommends reading the labels carefully to clearly understand the list of ingredients, directions, and any precautions. If you have questions, ask your pharmacist or health care provider.