Which over-the-counter pain medication is best for which situation?

If your son’s teeth hurt because he just had his braces tightened. If you’re running a fever or just generally feel achy, what over-the-counter pain medicine should you turn to?

With the many options for pain relief filling pharmacy aisles, how do you know which one to buy?

That depends on the type of pain you have and what health conditions you might have.

Types of over-the-counter pain medicine

There are two categories of pain relievers sold over the counter:

• Acetaminophen (Tylenol)
• Nonsteroidal anti-inflammatory drugs (NSAIDs). The three most common are:
• ibuprofen
• aspirin
• naproxen (Aleve)

The pros and cons of NSAIDs and acetaminophen

Acetaminophen comes with lower health risks unless you have liver disease or have more than two alcoholic drinks a day. NSAIDs are metabolized in your kidneys rather than in your liver. So, if you have liver damage or are at risk of it, an NSAID might be a better choice for you than acetaminophen.

NSAIDs can reduce both pain and inflammation while acetaminophen can only help relieve pain. If you’re in pain, say from a bruise or a toothache, your body sends out immune cells to fight the threat. That can cause redness or swelling in the area where you’re hurting, indicating that inflammation is going on. An NSAID could reduce your swelling and redness as well as your pain. Acetaminophen can only lessen your pain.

NSAIDs come with some health risks for someone with chronic kidney disease or gastrointestinal diseases. If you have a sensitive stomach or damage to your kidneys, you should consult with a doctor before taking NSAIDs. They can cause stomach upset and, in rare instances, stomach bleeding. They can also affect your kidneys.

Naproxen is longer-lasting than ibuprofen. You only have to take naproxen once every 12 hours. Ibuprofen wears off quicker, so it can taken every four to six hours.

If you’re in pain, you can safely use acetaminophen and an NSAID, such as ibuprofen, together as long as you don’t go over the daily maximum for each drug. That daily maximum is 4,000 mg of acetaminophen, 1,200 mg of ibuprofen or 660 mg of naproxen.

Sometimes the prescribed dose of the over-the-counter medications isn’t strong enough to stand up to your pain. If so, there are prescription formulations of the NSAIDS that offer pain medication at a higher dose. For example, the maximum dose of over-the-counter ibuprofen is 1,200 mg per day, but you can get a prescription for ibuprofen that’s as high as 3,200 mg a day.

Topical pain relievers

You have many options for over-the-counter pain lotions and gels that you can apply to your skin to get relief from injuries, sore muscles and joints.

Some topical pain relievers are:

• lidocaine
• counterirritants, such as menthol and methyl salicylate
• topical NSAIDs, such as diclofenac

Whichever you use, follow the directions on the box telling you how to apply it and how often. Don’t use them with a heating pad. The heat is likely going to alter how that medicine works and can cause you to absorb too much of the medicine at once.

For that same reason, it’s best not to cover the product with a tight, nonbreathable bandage or covering. The hot, humid environment that creates would mimic the effect of a heating pad. Instead, expose the skin to the air as much as possible.

Over-the-counter medications for short-term use

Regardless of the over-the-counter medicine you take, the medicine is only meant to be used for a couple of weeks at a time. If you take them for longer, it can be risky. If you’re taking pain medication by mouth, you may risk stomachaches, bleeding or liver damage.

If you’re still in pain after two weeks, consider talking to a health care provider. They can help get to the root of what’s causing the pain and treat the cause.