Many older adults have pain that does not go away. Deciding what type of pain medicine to take is not easy. Over-the-counter (OTC) pain relievers are medicines that you can buy without a prescription from your doctor. Two main types of OTC pain relievers are available. One type is acetaminophen (brand name: Tylenol). The second type is nonsteroidal anti-inflammatory drugs (also called NSAIDs). NSAIDs include the following:
•Aspirin (two brand names: Bayer, St. Joseph)
•Ibuprofen (two brand names: Advil, Motrin)
•Ketoprofen (one brand name: Orudis KT)
•Naproxen (one brand name: Aleve)
Acetaminophen seems to relieve pain and reduce fever by working on the parts of the brain that receive pain messages and control the body’s temperature. NSAIDs relieve pain and fever by reducing the level of hormone-like substances, called prostaglandins, which your body makes.
Prostaglandins cause pain by irritating your nerve endings. They also help your body control its temperature.
Acetaminophen and NSAIDs relieve pain caused by muscle aches, stiffness and reduce fever. NSAIDs can also reduce inflammation - redness and swelling. OTC pain relievers can be helpful in treating many types of pain, such as pain from arthritis, earaches, back pain and pain after surgery. They can also treat pain from the flu or a cold, sinusitis, strep throat or a sore throat.
Acetaminophen may help relieve headaches and other common aches and pains. It may be used safely by most people on a long-term basis for arthritis and other chronic painful conditions. NSAIDs may be helpful for pain from inflammation, such as muscle sprains. For most people, OTC pain relievers are all they need to control pain or fever. If an OTC drug does not help your pain or fever, or if you’ve been taking an OTC drug for more than 10 days for pain or 3 days for fever, call your health provider. These may be signs that you have a more serious problem or need a prescription medicine.
Side effects from OTC pain relievers are not common for healthy adults who only use pain relievers once in a while. However, side effects may be a concern for people who use pain relievers often, who have health problems or who take other prescription medications. If you have health problems, use pain relievers often or take prescription medications regularly, talk to your health provider before taking an OTC pain reliever.
Acetaminophen may cause liver damage in people who take very high doses or who already have abnormal liver function. To reduce your risk of liver problems, never take more than the recommended dose of acetaminophen. You generally should not take acetaminophen if you are already taking another product containing acetaminophen. If you have severe kidney or liver disease, or if you have 3 or more drinks that contain alcohol every day, you should talk to your health provider before taking acetaminophen.
With long-term use, NSAIDs may cause gastrointestinal (GI) problems.
These problems range from upset stomach to ulcers to GI bleeding. For minor stomach upset, eating some food or drinking some milk before you take an NSAID may help. Your risk of GI problems from NSAIDs goes up the higher the dose you take and the longer you take them. Drinking alcohol may increase this risk. Acetaminophen is much less likely than NSAIDs to cause GI problems. If NSAIDs are used regularly for many years, they may also hurt your kidneys. Your health provider can check for this with a blood test.
You should not take NSAIDs if you are allergic to aspirin or other pain relievers. Talk to your health provider or before you take an NSAID especially aspirin, if you:
•Take blood-thinning medicine or have a bleeding disorder
•Have bleeding in the stomach or intestines, or have stomach ulcers
•Have liver or kidney disease
•Have 3 or more drinks that contain alcohol every day
If certain drugs are taken at the same time, they can interact with each other and change the way your body processes them. For example, if someone who takes high blood pressure medicine also takes an NSAID, the high blood pressure medicine may not work as well as it should. Too, many OTC drugs contain the same pain reliever or contain ingredients found in prescription drugs. For example, many OTC cold medicines contain acetaminophen. If you were to take one of these products and also take acetaminophen separately, you would be taking much more acetaminophen than you intended.
When choosing an OTC pain reliever, check the drug label for possible side effects or interactions with other drugs you are taking - this will appear in the “Warnings” section. Also, check that you are not taking two medicines that contain the same active ingredient - this will appear in the “Active Ingredient” section. Always read and follow the directions on the label. Be sure you understand the label information before taking the medicine. If you have any questions, ask your health provider or pharmacist.
Over-the-counter pain medications can be useful and effective. Even though they are considered safe enough to be taken without a prescription, they are real medicines. It is important to discuss their use with a health provider, especially if they are being combined with prescription medications. For more information, contact your County Extension Agent. You may also visit the American Academy of Family Physicians website: http://familydoctor.org/online/famdocen/home/otc-center/basics/otc.html.