The Differences Between Over-The-Counter Pain Medications
There’s the row of painkillers at the local pharmacy. And there’s another row. And there’s another row below it. And, oh my goodness, is that a whole ‘nother aisle filled with the stuff? Extra-strength! Baby strength! Tylenol! Non-Tylenol! What to do?
Our advice: just pick the bottle with your favorite color. No, no. Don’t do that!
Is there a difference between all over-the-counter pain medications? You have a vague sense the answer is “yes” but can’t remember what to take when. All the while, you have a splitting headache and you need relief. But which one should you buy? And aren’t they all the same? Then you have to choose between regular strength, extra strength, brand name, generic, short-acting, long-lasting, etc., until you can’t read any more. So, not wanting to squat down and put more pressure on your already inflamed calf…or ankle…or heel…you grab the first package at eye level that seems ok and go with it (btw: did you know that items in retail stores are strategically placed? It’s a determining factor on how swiftly they sell. Check out the research).
The thing to understand is that there are really only three main forms of painkillers on the market – they’re just packaged in different ways, and yes, they may come in different strengths.
The Three Most Common Types of Painkillers
What you’re combing through are three types of over-the-counter (OTC) pain medications: nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen (Tylenol), and aspirin. Though these can come both OTC or with a prescription, depending upon the size of the dosage, we most often buy them in the drugstore aisle. These medications, though they’re safe when used as indicated, are not all the same.
Houman Danesh, MD, an Assistant Professor of Anesthesiology and Rehabilitation Medicine, and the Director of Integrative Pain Medicine at Mount Sinai hospital, helps us navigate the differences of pain medication in a recent article on The Huffington Post. Dr. Danesh clarifies the use–and misuse–of pain medication: what is safe for you to use based on your medical history, when to use what pain medication, and also offers alternative ways of alleviating your pain.2
There are three types of OTC pain medications: acetaminophen (Tylenol), nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen [Motrin] and naproxen [Aleve]) and aspirin. Here is an over-view of what Dr. Danesh has to say about each one.
- Acetaminophen is considered generally safe, but unlike NSAIDs, is processed through the liver. Alcohol is also processed through the liver, so if you’ve been heavily drinking, taking acetaminophen can make your liver harder, putting it at risk for failure. Stay away from acetaminophen if you’ve been drinking a lot (if you’ve been having 1 or 2 drinks per day, then it’s ok).
- Note that prescription pain medications such as Vicodin and Percocet are actually a combination of an opioid painkiller and acetaminophen, to increase they’re effectiveness. Therefore, don’t take acetaminophen on top of these medications, since your daily intake threshold can rise to dangerous levels.
- NSAIDs are usually taken as an anti-inflammatory, such as when you sprain an ankle. However, there is a danger of gastrointestinal bleeding, stroke, and even heart disease if taken at high dosages for a long period of time. In fact, the U.S. Food and Drug Administration recently strengthened their label warning for NSAIDs from “may” to “does” since more and more studies show these risks of NSAIDs3.
- If you have an inflamed, localized pain, you may try a lidocaine patch as an alternative to NSAIDs.
- Danesh lists a variety of situations in which one should avoid taking NSAIDs as well. You can find that list in the article.
- There has been plenty of evidence that aspirin, when taken daily later in your life at a low dosage (such as 75mg), can act as a blood-thinner, possibly helping you avoid stroke. However, there is still danger of gastrointestinal bleeding with aspirin, as with NSAIDs4, so be careful about the amount you take.
- Since aspirin does act as a blood thinner, you may notice for seven days after taking it that you may bruise a bit easier or bleed a bit more when, say, you cut yourself shaving.
Knowing when to use what OTC pain medication and distinguishing the different types of pain medication are important and does indeed make a difference. Though safe enough to not be regulated by the government, try not to rely too heavily on them. And when you do reach for some, be sure you know which one to take. Don’t, as Dr. Danesh says, just “pop them like candy.”
Of course, painkillers won’t work on all injuries or disorders. Sometimes the pain is just too intense. By all means, try the painkillers, but if they fail, Onward is here for you. To find our if you are a candidate for minimally invasive, quick-recovery surgery, please reach out by email or phone today.
- Hamacher Resource Group. How Shelf Placement Impacts Retail Buyers, Shoppers. July 17, 2014. accessed February 13, 2016, http://hamacher.com/how-shelf-placement-impacts-retail-buyers-shoppers/.
- Mount Sinai Health System. What You Don’t Know about Pain Medications Can Hurt You. Huffington Post (The Huffington Post), February 10, 2016, http://www.huffingtonpost.com/mount-sinai-health-system/what-you-dont-know-about-pain-medications-can-hurt-you_b_9201816.html?utm_hp_ref=healthy-living.
- Food and Drug Administration. Drug Safety Communication: FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes. accessed February 14, 2016, http://www.fda.gov/Drugs/DrugSafety/ucm451800.htm
- Catharine Paddock, Daily Aspirin – More Benefit than Risk? Medical News Today. October 22, 2015. http://www.medicalnewstoday.com/articles/243265.php.