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Over-the-counter pain relievers

Definition

Over-the-counter (OTC) pain relievers can help relieve pain or lower a fever. Over-the-counter means you can buy these medicines without a prescription.

The most common types of OTC pain medicines are acetaminophen, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs).

Information

Pain medicines are also called analgesics. Each kind of pain medicine has benefits and risks. Some types of pain respond better to one kind of medicine than to another kind. What takes away your pain might not work for someone else.

Taking pain medicines before exercising is OK. But do not overdo the exercise just because you have taken the medicine.

Read labels to learn how much medicine you or your child can take at one time and during the whole day. This is known as the dosage. Talk to your pharmacist or your child's health care provider if you are not sure about the correct amount. Do not give children medicine that is meant for adults.

Other tips for taking pain medicines:

• If you take pain relievers on most days, tell your provider. You may need to be watched for side effects.

• Do not take more than the amount recommended on the container or more than your provider tells you to take.

• Read the warnings on the label before taking the medicine.

• Store medicine safely and securely. Check the dates on medicine containers to see when you should throw them away.

ACETAMINOPHEN

Acetaminophen (Tylenol) is a non-aspirin pain reliever. It is not an NSAID, which is described below.

• Acetaminophen relieves fever and headaches, and other common aches and pains. It does not relieve inflammation.

• This medicine does not cause as many stomach problems as other pain medicines do. Acetaminophen is often recommended for arthritis pain because it has fewer side effects than many other pain medicines when used as directed.

• Examples of OTC brands of acetaminophen are Tylenol, Paracetamol, and Panadol.

• Acetaminophen prescribed by a provider is usually a stronger medicine. It is often combined with a narcotic ingredient.

PRECAUTIONS

• Adults should not take more than 4 grams (g) 4,000 milligrams (mg) of acetaminophen in a single day. Large amounts can harm your liver. Remember that 4 gs is about the same as 6 extra-strength pills (500 mg each) or 9 regular pills (325 mg each).

• People with liver disease should usually not take more than 2 g (2,000 mg) of acetaminophen in a single day. Check with your provider for guidance on what is safe for you.

• If you are also taking pain medicine prescribed by your provider, talk to your provider or pharmacist before taking any OTC acetaminophen.

• For children, follow package instructions for the maximum amount your child can have at one time and in a single day. Contact your child's provider if you are not sure about the instructions.

ASPIRIN and NSAIDS

• Aspirin and NSAIDs relieve fever and pain. They also reduce swelling from arthritis or a muscle sprain or strain.

• When taken for a short time (no longer than 10 days), aspirin and NSAIDs are safe for most people. They can cause stomach upset or even ulcers in some people. The longer you take them, the greater the chance of these side effects. If needed, contact your provider for advice on how to prevent them.

• Children under age 18 years should not take aspirin due to a risk for Reye syndrome.

• Some NSAIDs can be bought over the counter, such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).

• Other NSAIDs are prescribed by your provider.

PRECAUTIONS

• Do not give aspirin to children under 19 years of age. Reye syndrome can occur when aspirin is used to treat children who have viral infections, such as chickenpox or the flu.

Talk to your provider or pharmacist before using aspirin or any over-the-counter NSAID if you:

• Have heart disease, high blood pressure, kidney disease, liver disease, or stomach or digestive tract bleeding.

• Take other medicines, especially blood thinners such as warfarin (Coumadin),clopidogrel (Plavix), apixaban (Eliquis), dabigatran (Pradaxa), or rivaroxaban (Xarelto).

• Are taking NSAIDs prescribed by your provider, including celecoxib (Celebrex), or others.

References

Aronson JK. Non-steroidal anti-inflammatory drugs (NSAIDs). In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:236-272.

Dinakar P. Pain management. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 52.

House SA. Pain. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2025. Philadelphia, PA: Elsevier 2025:33-41.

Review Date: 10/27/2024

Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.