PAIN RELIEVER

Which Pain Reliever Is Right for You?

An aspirin may help your nagging headache, but will it reduce a fever, soothe a toothache, alleviate back spasms or reduce knee swelling?

Not all over-the-counter (OTC) pain medications, including aspirin, are created equal, according to Samuel Weiner, MD, a Virtua family physician.

"It can get confusing with the number of brands available on the market," says Dr. Weiner, "but there are only four major over-the-counter pain-killing products - aspirin, acetaminophen, ibuprofen and naproxen. Each has a different overall effect on the body."

Acetaminophen

(i.e. Tylenol, Panadol)

Acetaminophen is a pain reliever and fever reducer. Unlike the three other primary OTC pain medications, acetaminophen does not contain anti-inflammatory properties.

Conditions treated:

  • Arthritis pain
  • Back pain
  • Body aches associated with cold or flu
  • Fever*
  • Muscle aches
  • Sore throat
  • Toothaches

    *The children's version of acetaminophen, according to Dr. Weiner, is preferred to help reduce fevers in kids ages 2 to 11.

Check with your doctor if you have:

  • History of alcoholism
  • Liver problems

"Many over-the-counter products for cough, colds and flu contain acetaminophen, which is great at reducing fevers," says Dr. Weiner. "But you should look at the ingredients on these multi-symptom products. If they contain Tylenol, you should include that as part of a daily limit. The U.S. Food and Drug Administration (FDA) recommends 4,000mg as the maximum daily dose of acetaminophen for adults."

Aspirin

(i.e. Bayer, Bufferin)

Aspirin is often used as an analgesic (pain reducer) to relieve the body of pain, fever and inflammation. It is also used as a blood thinner and may treat or prevent heart attacks and strokes. Some individuals take low-dose aspirin to help ward off heart disease.

Conditions treated:

  • Arthritis pain
  • Fever
  • Headache
  • Joint stiffness
  • Menstrual pain

Check with your doctor if you have:

  • Blood disorder
  • Asthma or any other allergic disorder
  • Stomach ulcer
  • Liver or kidney problems

"Aspirin can be an effective pain reliever, but it should only be used for treatment or prevention of cardiovascular conditions under the supervision of a physician," says Dr. Weiner.

Ibuprofen

(i.e. Advil, Motrin)

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). It reduces hormones that cause inflammation and pain in the body and is used primarily for mild to moderate pain, fever and inflammation.

Conditions treated:

  • Arthritis
  • Backache
  • Bee stings
  • Headaches
  • Inflammation
  • Menstrual cramps
  • Minor injuries
  • Muscle aches
  • Toothache

Check with your doctor if you have:

  • Asthma
  • Heart disease
  • High blood pressure
  • Kidney problems
  • Liver problems
  • Stomach ulcer

"We use ibuprofen a lot for musculoskeletal injuries such as sprains and strains," says Dr. Weiner.

Naproxen

(i.e. Aleve)

Naproxen is also an NSAID. It typically has a more prolonged effect compared to ibuprofen. Naproxen is commonly used to relieve a higher level of pain, swelling and stiffness.

Conditions treated:

  • Arthritis
  • Gout pain
  • Fever
  • Inflammation
  • Kidney stone pain
  • Menstrual cramps
  • Migraine
  • Sprains/strains
  • Tendinitis

Check with your doctor if you have:

  • Asthma
  • Bleeding or blood clotting disorder
  • Heart disease
  • History of heart attack or stroke
  • Kidney disease
  • Liver disease

"Naproxen is more potent than ibuprofen and lasts twice as long," says Dr. Weiner. "Although naproxen may have a more potent effect than ibuprofen, it may also have more gastrointestinal side effects."

What about generics?

Can most individuals tell the difference between a name brand OTC medication and a generic version? Does the name brand work better than the generic one? According to Dr. Weiner, it is a "no" to both questions.

The FDA requires that generic OTC medications include the exact same active ingredients found in name brands. Generics cost less than brand-name equivalents because the latter are backed by huge (and expensive) promotional campaigns and investments in research and development.

"I encourage my patients to look for generics," says Dr. Weiner. "Generic over-the-counter pain relievers are less expensive, and they are just as effective as the name brands."

Updated June 6, 2016

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