What Is an OTC Pain Reliever?
An OTC, or over-the-counter, pain reliever is medicine you can buy at a pharmacy or store without a doctor’s prescription. You can get OTC pain relievers as pills, liquids, and creams.
When Should I Use an OTC Pain Reliever?
You can use OTC pain relievers to ease pain, fever, and inflammation from:
- Headaches
- Muscle soreness
- Arthritis
- Earaches
- Toothaches
- Backache or injury
- Surgery
- Cold or flu
- Sinusitis
- Sore throat
OTC pain relievers treat both acute pain (short-term pain with a known cause) and chronic pain (long-term pain).
What Are the Different Classes of OTC Pain Relievers?
There are three groups of OTC pain relievers:
Acetaminophen (Tylenol). You’ll find this ingredient in headache and cold medicines. While it eases pain, it doesn’t work on inflammation.
NSAIDs (Advil, Aleve, Motrin, and Naprosyn). This category includes medicines that relieve pain, fever, and inflammation. NSAIDs include aspirin, ibuprofen, and naproxen.
Lidocaine. This is a pain-relieving medicine that you apply to your skin. It comes in a gel or patch.
How Do OTC Pain Relievers Work?
Acetaminophen
Your brain gets pain messages and controls your body temperature. Acetaminophen works on these parts of the brain to ease pain and lower fever.
NSAIDs
There are substances that your body makes called prostaglandins. They aggravate the endings of your nerves, causing you to feel pain. NSAIDs work by lowering prostaglandins in your body and, as a result, soothing pain.
Lidocaine
This numbing medicine, also known as a local anesthetic, works by blocking the nerves in your skin from sending pain signals to your brain.
How Do OTC Pain Relievers Differ?
Over-the-counter pain relievers mostly differ in their effect on the body. NSAIDs lower inflammation and pain by blocking the production of prostaglandins, while acetaminophen and lidocaine work by blocking pain signals to the brain. The potential side effects of these drugs may also differ.
What Are the Risks and Benefits of OTC Pain Relievers?
Like all medicines, over-the-counter pain relievers can cause side effects when used to treat painful conditions.
Acetaminophen benefits and risks
Acetaminophen eases pain and brings down a fever with fewer side effects than NSAIDs. But liver damage can happen with high doses of acetaminophen; overdose of the drug is a common cause of acute liver failure.
Also, be careful about mixing acetaminophen with products like other pain relievers and cold medicine. People who regularly drink a lot of alcohol, have liver damage, or who take the blood thinner warfarin should avoid acetaminophen.
NSAID benefits and risks
NSAIDs work well to lower a fever, ease cramps during your period, and relieve muscle aches and swelling. When it comes to aspirin, the benefits depend on the dose. You’ll take larger doses of aspirin to ease pain, inflammation, and a fever, while low doses help protect against heart attacks and strokes.
NSAIDs can cause stomach problems, including pain, bloating, heartburn, and ulcers. Aspirin poses a higher chance of bleeding in your gut than ibuprofen and naproxen. Taking too much of an NSAID also raises your risk of a heart attack, stroke, and kidney failure.
Staying within the daily limit of an NSAID can help you avoid these health issues. Talk to your doctor before you take an NSAID, especially if you take a blood thinner or blood pressure medicine, or if you have a peptic ulcer, weakened kidneys, heart disease, or high blood pressure.
Aspirin comes with special precautions because of the risk of overdosing, which can’t be reversed. If you’ve taken too much aspirin, call 911 or get medical help right away.
Lidocaine benefits and risks
Unlike NSAIDs and acetaminophen, which come in a pill form, lidocaine is a topical medicine – it's applied to the skin. This may be helpful if you take several oral drugs or have stomach problems related to taking NSAIDs.
Possible side effects of lidocaine include skin reactions such as itching, tingling, paleness, redness, and swelling. In rare cases, you could have an allergic reaction.
How Do I Know Which OTC Pain Reliever is Right for Me?
The right OTC pain reliever depends on the type of pain you have, any other health conditions, and your age.
Type of pain
- Muscle aches and pains. Doctors often suggest NSAIDs such as ibuprofen or naproxen since they relieve inflammation.
- Headache. Acetaminophen or NSAIDs work well for this type of pain.
- Fever. Acetaminophen is usually the first choice for lowering a fever.
- Period cramps. NSAIDs tend to work best for this kind of pain.
- Arthritis. NSAIDs, as a pill or topical, often help to ease pain and inflammation related to arthritis.
Health conditions and age
- Health conditions. Talk to your doctor before taking an OTC pain reliever if you have liver, kidney, or heart problems, or if you take blood thinners.
- Age. Before giving pain relievers to children under 6 months old, talk to their pediatrician. For children over 6 months, use age-appropriate doses based on weight. Children under 18 shouldn’t take aspirin due to the risk of Reyes syndrome, and avoid giving naproxen to kids under 12.
Show Sources
Photo Credit: Yuri Arcurs/Dreamstime
SOURCES:
Harvard Health Publishing: "Know your pain relievers."
MedlinePlus: "Pain Relievers."
Familydoctor.org: "Pain Relievers: Understanding Your OTC Options."
Houston Methodist: "Painkillers: Which OTC Medication is Right for Me?"
Mayo Clinic: "Lidocaine (topical application route)."
National Health Service (U.K.): "About lidocaine skin cream," "Side effects of lidocaine skin cream."
Scripps: "How to Choose Over-the-Counter Pain Medicine."
Duke Health: "What Kind of Pain Reliever Is Best for Me?"
Samaritan Health Services: "Know Your Pain Reliever Options & How to Choose Between Them."
Arthritis Foundation: "Comparing Pain Meds for Osteoarthritis."
