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What are the best over the counter (OTC) pain medicines?

Answered by Shivam Patel, PharmD, BSPS, RPh | Posted February 25, 2020

Commonly, it’s headaches. Sometimes it's that occasional elbow to the nose or banging your knee on the corner of the bed in the dark. Regardless of how it manifests, we all have experienced some pain that causes us to eagerly search our cabinets for the strongest over-the-counter (OTC) medication, like ibuprofen or acetaminophen, to help ease the suffering. The great thing about OTC pain meds is that, unlike prescription narcotics, they don't make you drowsy or feel unable to function, and, of greater importance, don’t get you hooked!

 

Generally, OTC medications are inexpensive, easily accessible at your local pharmacy, and come in an array of brand-name and generic options. The two most common ones include acetaminophen and the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen, and (aka: good old Tylenol and Advil, respectively). These two medications are safe and effective in treating pain for short-term use, but, unlike Advil, Aspirin, or Aleve (naproxen), Tylenol is not an NSAID. Medical professionals often recommend NSAIDs and Tylenol for different types of pain.

 

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In Tylenol We Trust

Tylenol -- which is the brand name for acetaminophen, -- is great to use when you are experiencing the following:

 

  • Headache
  • Fever
  • General aches or pains without swelling

 

Other brands for acetaminophen include Acephen, Feverall, or Paracetamol.

 

Tylenol works in the part of your brain that controls the perception of pain and body temperature, but it is not an anti-inflammatory medication. That means if you are experiencing any swelling, then Tylenol is not the drug of choice.

 

It is important to know that Tylenol is also used in many combination medications. Pay attention to this if you are taking several medications. You should not take Tylenol if you have liver disease or consume large amounts of alcohol. College students, take note. With that said, Tylenol with an occasional drink will not harm a healthy individual, however again it should not be taken with large quantities of alcohol.

 

How much Tylenol should you take?

As directed on the medication itself, you should take 325mg - 650mg of Tylenol every 4 to 6 hours as needed for controlling fever and pain. I always recommend starting on the lower end of the dose range and monitoring to see how your body responds before increasing your dose. Do not exceed 4000mg in one day, as taking too much acetaminophen can induce liver damage.

 

IMPORTANT SAFETY REMINDER: Taking more than 4000mg of acetaminophen in one day is dangerous to your health. You should be particularly careful to not exceed this threshold when taking combination medicines that include acetaminophen.

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Ouch, Advil please help!

Advil is a commonly-used NSAID also known as ibuprofen. Other brands include Ibu, Motrin, Iprin, and Genpril. Advil is effective to use when you are experiencing the following:

 

  • Headache
  • Pain related to inflammation or swelling (sprain, broken bone, teeth, joints, arthritis, etc.)
  • General aches or pains

 

Ibuprofen works differently than acetaminophen. Ibuprofen and other NSAIDs work by decreasing and blocking prostaglandin production in the body. Prostaglandins are released by your body in response to an injury or sickness, which cause swelling and pain. By decreasing these prostaglandins, you start to feel better.

 

Ibuprofen should not be taken if you have kidney disease or improper kidney function. You may experience some normal side effects, which include upset stomach, indigestion, and nausea. There are some concerns with gastrointestinal bleeding in patients who are elderly, have an ulcer disease, smoke often, and consume alcohol often. You won't have to worry about these concerns if you don't fit the criteria stated above.

 

Ibuprofen is my recommendation as the strongest OTC anti-inflammatory to treat pain associated with swelling.

How much ibuprofen should you take?

You should take 200mg - 400mg of ibuprofen every 4 to 6 hours. Do not exceed 1200mg in one day without speaking to your health care provider.

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Aleve, can you Alleviate this pain?

Aleve is another commonly-used NSAID. Aleve is the brand name for naproxen. Another brand name for naproxen is Naprosyn. Aleve is effective when you are experiencing the following:

 

  • Headache
  • Pain related to inflammation or swelling
  • General aches or pains

 

Some patients respond better to ibuprofen and some to naproxen. You will have to see what works best for you. The side effects of Aleve are the same as ibuprofen.

 

How much Aleve should you take?

You should take 220mg of Aleve every 8 to 12 hours. Do not exceed 1000mg in one day.

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So you don’t want to take pharmaceutical drugs, whether prescription or OTC. What are the best natural treatments and pain killers?

Usually our first response to pain or injury is to grab one of the medications described above. But, sometimes, this isn't always the best option, especially if there are drug interactions or certain diseases of concern. If you still wish to relieve your pain, here is a sample list of treatments and natural pain killers:

Natural Pain Killers

  • Ice and Heat

    Ice is extremely important during the first 48 hours after an injury that caused swelling. Icing for 20 minutes at least 3 to 4 times a day is beneficial to reduce swelling. For joint pain or arthritis, moist heat packs may help reduce pain. You can find moist heat packs that you can warm up in your microwave at local pharmacies and many large retail outlets.

  • Turmeric

    A spice, one that is found in almost all Indian curry dishes, actually has an active ingredient called curcumin that is a great antioxidant. It can help protect your body from cellular damage and reduce inflammation. It is commonly available for cooking at grocery stores. It is also found in capsule forms at your local pharmacies or natural health product stores.

  • Cloves

    Another spice often used in cooking has an active ingredient called eugenol. It provides natural pain relief for inflammation, headaches, and toothaches. Eugenol is available in oil form, which you can apply topically, such as directly on your tooth when in need of some relief. It can be purchased at natural food stores and local pharmacies.

To learn more about natural products to treat pain see product reviews by ConsumerLab.com, a company with which PharmacyChecker is affiliated.

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Learn more about pain medication and ways to afford your prescriptions

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How can patients reduce prescription drug costs at the pharmacy counter?

Do you have questions or concerns about prescription pain medication savings, whether locally or online? We’re here to help.

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