Acetaminophen, ibuprofen or aspirin, which pain reliever is right for you?

Posted: March 2, 2023

Several options are available for over-the-counter (OTC) pain relievers. Dr. Jacob Lonsdale, a non-operative pediatric orthopedist at Marshfield Clinic Health system, helps break them down, while reminding you to always talk to your provider before taking a new medication.

OTC pain reliever basics

Acetaminophen is commonly used for:

• Headaches
• Menstrual cramps
• Minor aches and pains
• Fever

An example brand of acetaminophen is Tylenol®. This pain reliever does not reduce inflammation or swelling caused by an injury. It also usually does not cause upset stomach like some other OTC pain relievers. "Many other OTC medications, like those for cold or flu, contain acetaminophen," Dr. Lonsdale said. "Read labels carefully so you do not take more of the medicine than recommended." Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) mostly used for:

• Pain management
• Inflammation and swelling
• Fever
• Menstrual cramps

Ibuprofen is marketed under brand names like Advil® and Motrin®. It may cause an upset stomach if not used at the correct dosage. Take ibuprofen on a full stomach or with a glass of milk, to reduce that likelihood. Use caution. Excessive dosing can lead to long-term effects of stomach bleeding, increased blood pressure, fluid retention and reduced kidney function. Naproxen​​ sodium is used for:

• Pain
• Inflammation and swelling
• Joint stiffness caused by arthritis, bursitis or gout and similar conditions
• Fever

Naproxen sodium is marketed under the brand name Aleve®. "This is a longer-lasting medication than acetaminophen or ibuprofen, so it should be taken less frequently, reducing risk for upset stomach," Dr. Lonsdale said. Use caution. Because of possible allergic reaction, naproxen sodium should not be given to children under age 12 without physician approval. Yet another pain relief option is aspirin.​ Unless specifically directed by your provider, those under age 20 should not take aspirin. At this age, aspirin increases risk of Reye's syndrome, a serious disease that can cause drowsiness, confusion, seizures, coma, and in severe cases, death. Aspirin is a NSAID and should not be taken with similar medications like ibuprofen and naproxen.

There are other options

In many cases, providers recommend people first use ice, rest, compression and gentle physical therapy for injuries. Pain relievers can follow these treatments, if needed. You might also talk to your provider or trainer about topical products. Research is also growing for some natural products like curcumin and resveratrol. Curcumin is found in turmeric spice and is known for its anti-inflammatory properties. One study found its anti-inflammatory effects appear to be comparable to steroidal drugs and NSAIDS. Resveratrol is found in grapes, wine, nuts and berries. Its list of potential health benefits is long, and includes anti-inflammatory antioxidant and anti-cancer properties. However, resveratrol doesn't dissolve into water very well and has low bioavailability. That means the fraction of an administered dose that ultimately impacts one's body is lower than desired.

Ask questions, be mindful

"It's simple to compare which OTC medications can do what. It's not simple to list possible side effects. How your body reacts to any medication has a lot to do with your health, underlying medical conditions and regular medications or prescriptions," Dr. Lonsdale said. Always carefully read medication labels. Pay close attention to warnings, the "ask a doctor before use if" section and directions. Finally, ask your provider or trainer about other options to find the best fit for you. [button-green url="/-/media/marshfieldclinic/images/shine365/2023/03/30966-001.pdf" target="_self" position="center"]Print infographic[/button-green] [divider]

For questions about pain relievers, talk to a Marshfield Clinic Health System provider.

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