 Your choice of a pain reliever depends on several factors, including what is causing your pain and whether you also need help against inflammation. All pain relievers also help reduce fever. The most commonly used anti-fever drugs are acetaminophen (brand name Tylenol) and >ibuprofen (Advil and Motrin). The two drugs are equally effective in reducing fever, but ibuprofen may work faster. Other fever reducers include >aspirin, >naproxen (Aleve), and ketoprofen (Orudis). Never give aspirin to a child with chickenpox or any viral infection. It can cause a rare but potentially fatal complication called Reye's Syndrome. To treat pain, you can choose either acetaminophen or one of the many nonsteroidal anti-inflammatory drugs (NSAIDs). Examples include aspirin, ibuprofen, naproxen, and ketoprofen among others. Acetaminophen and the NSAIDs are all roughly equivalent as pain relievers. But since acetaminophen is not an anti-inflammatory drug, it is not as effective in treating pain associated with swelling. Your choice of pain reliever also depends on the type of pain you have:
To reduce pain associated with arthritis, the American College of Rheumatology recommends that you first try acetaminophen rather than NSAIDs. In clinical studies, the maximum recommended daily dose of acetaminophen (4 grams) relieved pain as well as ibuprofen--and acetaminophen is much less likely to cause ulcers, bleeding, or other potentially serious gastrointestinal side effects.
To reduce pain associated with menstruation, try ibuprofen, naproxen, or ketoprofen. >Midol, a combination product that contains acetaminophen, caffeine, and pamabrom (a water pill to reduce bloating), can also be effective. Some Midol products contain pyrilamine, which will help you sleep.
To reduce pain associated with a migraine headache, try acetaminophen (Tylenol), aspirin, ibuprofen (Motrin or Advil), naproxen (Aleve), ketoprofen (Orudis KT), or combination products such as >Excedrin Migraine (which contains a combination of caffeine, acetaminophen, and aspirin). In general, these over-the-counter products are all equally effective against headaches. But some people believe the combination products work better.
To reduce the pain of a tension headache, try Excedrin or ibuprofen.
Over-the-counter pain medicines are designed to treat specific, temporary conditions in otherwise healthy people. Please check with your doctor or pharmacist if you have a chronic medical condition or are taking prescription medicines. Unless otherwise directed by your doctor, use over-the-counter pain medicines for the shortest time necessary. This reduces the risk of serious side effects. Some serious side effects that may occur with long-term use of NSAIDs include cardiovascular (heart) issues such as heart attack or stroke, and gastrointestinal (stomach) bleeding or ulcers. Contact your doctor if the pain or fever increases or continues for more than seven days. Sources:
"Recommendations for the medical management of osteoarthritis of the knee." Arthritis & Rheumatism, Vol. 43, No. 9, September 2000.
American College of Rheumatology subcommitee on osteoarthritis guidelines.
Drug Facts and Comparisons. Facts & Comparisons, 2006.
Handbook of Nonprescription Drugs. American Pharmaceutical Association, 2000.
Medline Plus. Medline, 2006.Micromedex® Healthcare Series. Thomson Micromedex, 2006.
Schachtel B. "Nonprescription ibuprofen and acetaminophen in the treatment of tension-type headache," Journal of Clinical Pharmacology (36) 1996.
Siberstein S. Headache in Clinical Practice. Isis Medical Media, 1998.
This reply prepared 7/2/2001.
This information updated 1/25/2007.
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