OTC Pain Relief: Which Is Safest?

Different types of over the counter pain pills scattered on a surfaceWhen you have a painful joint or tension headache and go to your pharmacy for pain relief, you can be easily overwhelmed with the options for over-the-counter medication (OTC). There are the standards: Aspirin, Motrin, Advil, Aleve, and Tylenol, and then there are a host of generic choices that contain the active ingredient from these same best selling brands.

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There has been a lot of talk lately about the dangerous side effects of these medications. Too much Tylenol can cause liver damage, Motrin can be bad for your heart, and Aleve can cause bleeding ulcers. So how do you decide which is best to take?

Unfortunately the answer is complicated. These medications are frequently assumed to be safe merely because they are available without a doctor’s prescription. But the reality is any medication, in the wrong circumstance or at the wrong dose, has the potential to cause harm.


Let’s start with the biggest seller, acetaminophen , the ingredient in Tylenol and countless other pain and cold medications. The FDA has just decreased the available dose of acetaminophen due to multiple people suffering liver damage when taking too much.

Many wrongly believe that if one or two pills provides some relief, three or more will provide additional relief. That mistaken assumption could cost you your life, and researchers found that the higher doses don’t provide much additional relief, but do cause much more risk. With these recent changes, it is especially important to read the instructions on the bottle, and follow them closely.

The ingredients in Aspirin, Advil and Motrin (ibuprofen), and Aleve (naproxen) belong to a class of medications called NSAIDs . This class of anti-inflammatory medications provide good pain relief from arthritis, headaches, toothaches, menstrual cramps, and an array of other common ailments. The problem with this class is they can also upset your stomach, cause bleeding problems, and raise your blood pressure leading to an increased risk of heart attack and stroke.

The FDA recently reviewed a study looking more closely at NSAIDs (ibuprofen and naproxen) and their effect on heart disease. They surprisingly found that the ingredient in Aleve (naproxen) did not cause as much risk of heart attack and stroke than the more popular ingredient, ibuprofen, found in Advil, Motrin, and countless other generic pain relievers.

The FDA is suggesting that people with a risk for heart disease or stroke are better off taking naproxen than ibuprofen, and are suggesting the manufacturers add this information to their labeling.

All over-the-counter medications can be more dangerous in people over 60, those who drink more than three alcoholic beverages a day, have heart, liver, or kidney disease, or have bleeding problems. If you have these or other health issues, you will want to be particularly cautious when taking over-the-counter medications.

So if you’re in pain, what do you take? The easy answer, even if it’s an over-the-counter medication, is to follow the dosing instructions and precautions, consider what other health issues you have, and above all, ask your doctor.


Visit the BlackDoctor.org Heart Health center for more articles and tips.

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