American consumers love to have choices, but when it
comes to pain relief, we just want something that works fast,
effectively and without troublesome side effects.
"Although we're lucky to have these options at our fingertips,
drugs that are usually very safe, cheap and beneficial in
relieving pain for many people, it can sometimes be confusing,"
says Dr. William Norcross, chief of family medicine at the
University of California San Diego Medical Center.
"Go with the one that works best for you," he continues, noting
that it's important to consider your individual circumstances,
pre-existing conditions and the risks of each medication.
"Over time, you'll find out which of these over-the-counter
drugs does the best job for you and your (particular pain)," he
says. "Stick with that one."
San Diego doctors look at the advantages and disadvantages of
each of these OTC pain relievers and which is most effective for
certain common ailments.
ASPIRIN
You may know it as: Bayer, Aspergum
Pros: Effective pain reliever and anti-inflammatory drug.
Cheap. Thins the blood so it's protective against heart attacks
and stroke.
Cons: Can be irritating to the stomach. Has a short shelf-life,
so you need to take it every four hours, which increases the risk
of stomach problems. Large doses may cause tinnitus, ringing in
the ears.
Contraindications: Aspirin should not be taken by children
under 18 because of the risk of Reye's syndrome, a rare but very
serious liver and central nervous system condition.
People with asthma should consult their doctor before taking
aspirin since there's "a strong correlation between asthma and
aspirin and other nonsteroidal anti-inflammatory drugs," says Dr.
Davis Cracroft, medication safety officer and emergency physician
at Scripps Mercy Hospital. Shouldn't be taken by people with
stomach ulcers or with a history of internal bleeding.
Not recommended for pregnant or breast-feeding women.
Note: All of the nonsteroidal anti-inflammatory drugs (NSAIDs),
including aspirin, ibuprofen and naproxen, can cause stomach and
GI tract irritation. To reduce this risk, take with food or as an
added measure take with stomach-protecting drugs such as Prilosec,
Zantac or Tagamet.
IBUPROFEN
You may know it as: Advil or Motrin
Pros: Good anti-inflammatory medication. Generally safe and
cheap. Doesn't need to be taken as frequently as aspirin, usually
every six hours.
Cons: Does not offer the same cardiovascular protection that
aspirin does. Can irritate the stomach and GI tract. May increase
the risk of heart attack or stroke, especially for those who have
taken it for a long time.
Contraindications: People shouldn't use ibuprofen if they have
a history of bleeding disorders or if they have stomach problems
or an ulcer. Prolonged use may cause kidney problems.
As people get older, it's recommended they lessen the dose of
ibuprofen since, if taken regularly or in high doses, it can cause
high blood pressure, Cracroft says.
Not recommended for pregnant women and only short-term use for
breast-feeding women.
NAPROXEN SODIUM
You may know it as: Aleve or Naprosyn
Pros: Very good anti-inflammatory drug. Usually safe and cheap.
Only needs to be taken every eight to 12 hours.
Cons: Can be very irritating to the stomach and GI tract. Does
not offer cardiovascular protection. May increase the risk of
heart attack or stroke, especially for those who have taken it for
a long time. Prolonged use may cause kidney problems.
Contraindications: People shouldn't use naproxen if they have a
history of bleeding disorders, stomach problems or an ulcer. Not
recommended for pregnant or breast-feeding women.
ACETAMINOPHEN
You may know it as: Tylenol
Pros: One of the safest pain relievers and fever reducers. No
adverse effects on the stomach or GI tract. Safe for children. The
safest pain choice if you also take a daily aspirin to protect
your heart. Safe for pregnant women.
Cons: When taken regularly or in high doses, it can cause
injury to the liver or liver failure. Not an anti-inflammatory
drug.
Contraindications: Don't take if you have liver disease. People
who consume more than two alcoholic drinks a day should not take
acetaminophen because of risk to the liver. People with healthy
livers should take no more than 4,000 milligrams a day (about
eight tablets).
Since acetaminophen is often compounded in other types of
drugs, including cold medications and narcotic drugs, it's
important for regular acetaminophen users to read ingredient
labels and talk to your doctor before taking other medicines.
Migraine pain relievers:
Products such as Excedrin Migraine are a mixture of
acetaminophen, aspirin and caffeine. The pain of migraines is
caused by the dilation of the arteries, and caffeine helps
constrict those arteries, Norcross explains. If you're very
sensitive to caffeine, beware of taking these migraine medications
at bedtime.
Pain relievers with sleep-aid:
Pain meds such as Tylenol PM and Advil PM contain the drug
diphenhydramine, commonly known as Benadryl, which acts as a
gentle sleep aid for some people. Norcross cautions about taking
too much or using the product if you're already taking an
antihistamine for allergies or a cold. It can dry you out,
resulting in constipation, urinary retention, dry eyes and dry
mouth.
Erin Hobbs contributed to this article.
