So many things can go wrong with our bodies at a moment’s notice. We can tweak a back, twist an ankle, or take a tumble. We can run a fever, get a headache, or have a cold. These experiences don’t necessarily warrant a doctor’s visit, but we do want to relieve any pain, discomfort or fever.

Today, we have a wide variety of over-the-counter (OTC) medications to treat life’s little curveballs, but all these options can create problems for patients. First, so many choices can make it difficult to figure out which OTC pain-reliever is right for your symptoms and for your overall health. Second, the ease of access makes accidental over-use—taking too much for too long—far too common.

Tablets Pharmacy is here to help you make better and safer choices when you find yourself facing the mild to moderate pains of life. Some of the most common OTC Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and other pain relievers are reviewed here.

Aspirin
Salicylic acid, the chemical that makes Aspirin effective in managing pain, has been used by humans in natural forms for thousands of years. The use of Aspirin itself spans over 100 years, though its use as a pain reliever has waned. Aspirin blocks the production of chemicals that can cause fever, pain, swelling, and blood clots. These mechanisms make Aspirin useful for treating mild to moderate pain of various causes:

• headaches
• menstrual periods
• arthritis
• toothaches
• muscle aches

Because Aspirin impacts clotting, it can also be used in low doses to prevent heart attacks. Never begin an Aspirin regimen without speaking to your doctors, as Aspirin increases your risk of bleeding. Other side effects include nausea, vomiting, and stomach pain, which increase the risk of developing stomach ulcers and bleeding.

Aspirin isn’t recommended for children under 12. It shouldn’t be used to treat pain from certain viral infections as Aspirin impacts 90% of Reye syndrome patients.

Acetaminophen
Acetaminophen works on the central nervous system rather than by disrupting chemical signals throughout the body, which makes it a valuable alternative to NSAIDs. In fact, Aspirin’s association with Reye syndrome drove scientists to push for over-the-counter approval for acetaminophen in 1950.

Since then, the drug has been used to treat fevers and pain from a range of causes including:

• headaches
• muscle aches
• menstrual periods
• colds
• sore throats
• toothaches
• backaches
• discomfort from vaccinations and injections

Unfortunately, research has shown more and more that acetaminophen can quickly become toxic to the liver, and that this threshold is much lower than originally found. The NIH estimates Acetaminophen toxicity accounts for 500 deaths and 50000 emergency room visits annually and is the most common cause of drug-related liver failure.

Because of this, correct dosage and limited duration of use is extremely important. Current guidance recommends adults take no more than 4000 mgs of acetaminophen from all sources in a single day. Experts note that 3000 mg is likely the safest maximum amount, especially if a patient uses acetaminophen often.

For children over 2 years of age, dosage depends on weight; follow the charts on the medication packaging and check with your doctor or Tablets pharmacist. Pediatric side effects of acetaminophen are mild when used appropriately, though there is a small chance of allergic reaction. Watch for signs such as a rash, hives, sore throat, or difficulty breathing and get to the nearest Urgent Care or ER as soon as possible.

Ibuprofen
Scientists developed Ibuprofen in the 1960s to treat Rheumatoid Arthritis. The hope was that Ibuprofen would provide relief without as many side effects or long-term consequences as other pain relievers. Not only does Ibuprofen ease pain and lower fever, but as an NSAID, it also reduces inflammation, allowing for additional relief beyond what Acetaminophen can provide. As such, ibuprofen is recommended to relieve minor aches and pains from:

• headaches
• arthritis
• menstrual periods
  common colds
• toothaches
• backaches

Adults and teens are advised to take 400 mgs every 4 to 6 hours, as needed. Children over 6 months can take a weight-appropriate dose not to exceed 40 mgs per day.

While dosage and use are a little more forgiving than the toxicity levels for Acetaminophen, Ibuprofen does have with side effects and should be used only as needed. Ibuprofen use raises the risk of a heart attack, and the risk increases with larger dosages and longer periods of time taking the drug. Ibuprofen is also associated with stomach upset, and prolonged use can cause stomach or intestinal bleeding.

Naproxen
Naproxen is an NSAID, similar to ibuprofen but with a slightly different formula that extends the time the medicine works in the body. It was approved for prescription use in the 1970s, again to provide safer and longer pain relief for arthritis patients. In 1994, the drug was approved as an OTC pain management option to treat aches and pains such as:

• headaches
• arthritis
• menstrual periods
• common colds
• toothaches
• backaches

Just like Ibuprofen, Naproxen blocks chemical signals in the body but the method in which it blocks those signals lasts longer and can provide compounding relief when taken in succession. This makes it a useful option for treating chronic pain such as arthritis.

Again like Ibuprofen, Naproxen increases the chance of heart attack or stroke and can lead to stomach issues including bleeding. Naproxen usage also brings additional dangers of decreased kidney function and increased liver enzymes. For these reasons, doctors advise patients to use the lowest effective dose for the shortest amount of time.

Naproxen is not indicated for use by children.

Over-the-counter pain relievers have been an enormous benefit for people suffering from minor aches and pains for decades, but just because it’s sold without a prescription doesn’t mean a drug is safe in unauthorized doses for extended periods of time. Ask your Tablets Pharmacist if you’re taking over the counter medications safely. We are always happy to help!