How to choose the right over-the-counter pain medication for you

What the best over-the-counter medication to stop your pain?

Emory Internist Dr. Sharon Bergquist, says you've got two main choices at the drugstore..

"One type is Acetaminophen, or Tylenol," Dr. Bergquist says.  "The other type is the family we call NSAIDs, or non-steroidal anti-inflammatory drugs."

Think aspirin, ibuprofen or naproxen.  All NSAIDs.

But there are some key differences in how the two types of drugs work.

"One of the main differences is that the NSAID family are anti-inflammatories," says Dr. Bergquist.  "They're not just pain relievers; they reduce inflammation. Tylenol has no anti-inflammatory properties, so it is purely a pain reliever."

So, for a headache or fever, Acetaminophen or Tylenol may be your best bet.

"If you sprain your ankle, if you stub your toe, inflammatory type injuries, you're better of with an anti-inflammatory pain reliever," Dr. Bergquist says. 

But what about possible side effects? 

Bergquist says there can be plenty.

"I think a lot of people underestimate the risks of over-the-counter pain medications," she says. 

Read the label, take only the recommended dose, and Dr. Bergquist says keep in mind most side effects come with regular use. 

"But, if you just use them periodically, you should be fine," she says. 

Anti-inflammatories like ibuprofen can cause stomach pain, heartburn and stomach ulcers.

"If you have a sensitive stomach, always take it with food," says Dr. Bergquist.  "That is really critical."

NSAIDS, especially aspirin, are also bloodthinners, so they can increase your risk of bleeding. 

And Dr. Berquist says they can raise blood pressure, and cause kidney problems, especially in people with underlying kidney disease. 

If you take Tylenol, or Acetaminophen , watch for common symptoms like nausea, stomach pain, loss of appetite, headache, and dizziness.

Taking more than the recommended amount of Tylenol or Acetaminophen has also been linked to liver toxicity, and even liver failure.

"Acetaminophen goes through your liver," Dr. Bergquist explains.  "So if you have underlying liver disease you should steer clear of Acetaminophen.  And, if you drink alcohol, which is also broken down by the liver, you should steer clear of Acetaminophen."

If you regularly take a medication like Motrin or Tylenol, Bergquist says tell your doctor.  

Some side effects like liver and kidney problems can only be detected through bloodwork.

Bottom line?  Dr. Bergquist says follow the directions and don't take above the recommended daily amount listed on the box.

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