Proceed with caution when it comes to over-the-counter pain meds

Reading Eagle photo illustration: Bob Schneider | Acetiminophen and NSAIDs are generally safe and effective,but a Tower Health Medical Group doctor warns that side effects are possible.

There are two categories of OTC pain medications: acetaminophen and nonsteroidal anti-inflammatory drugs, or NSAIDs.

The most common pain reliever containing acetaminophen is Tylenol, but the drug is also contained in some cold and flu medicines and other OTC medications.

The broad NSAIDS category includes aspirin, ibuprofen and naproxen. Common brands of aspirin include Bayer and Bufferin, while ibuprofen is sold as Advil or Motrin IB. A common brand of naproxen is Aleve.

With drug overdose deaths occurring at an epidemic rate, prescription painkillers, which are blamed for many of those deaths, rightly have been garnering a lot of attention.

Another type of pain medicine, however — the pills, liquids, capsules, creams and sprays that are sold over the counter in drug stores and other locations — flies largely under the radar.

Over-the-counter, or OTC, pain medications are some of the most frequently purchased medicines. Generally known as analgesics, pain medications are used by many people to treat headaches, arthritis, back pain, toothaches, menstrual period pain, sprains and other conditions.

And, while OTC pain medicine is generally safe and effective, consumers should understand the different varieties available, how they work and possible side effects, advised Dr. Lisa Gallagher, a family medicine doctor with Tower Health Medical Group.

Generally, Gallagher explained, there are two categories of OTC pain medications: acetaminophen and nonsteroidal anti-inflammatory drugs, or NSAIDs.

The most common pain reliever containing acetaminophen is Tylenol, but the drug is also contained in some cold and flu medicines and other OTC medications.

Acetaminophen is helping in treating headache, fever and arthritis pain because it works on the parts of your brain that receive pain messages and control body temperature.

The broad NSAIDS category includes aspirin, ibuprofen and naproxen. Common brands of aspirin include Bayer and Bufferin, while ibuprofen is sold as Advil or Motrin IB. A common brand of naproxen is Aleve.

NSAIDS are used to relieve pain and reduce fevers, but these medications also work to reduce inflammation, making them particularly effective in treating muscle and joint pain.

They work by blocking enzymes that help make chemicals that result in pain.

According to Gallagher, our bodies process acetaminophen and NSAIDS differently.

“Acetaminophen is primarily processed through the liver, while NSAIDs are processed through the kidneys,” she said.

People who have liver or kidney problems should be very careful about taking OTC pain medications and should always consult with their doctor about what medicines they use, Gallagher said.

Also, she said, OTC pain medicine should be used only when needed, not as a habit.

“People sometimes start taking something for pain, and it ends up becoming kind of a regular thing,” Gallagher said. “I think that happens quite often.”

While most people can occasionally take OTC pain medicine without any problem, side effects are possible.

Liver damage can result from using too much acetaminophen, while NSAIDS can increase the risk of heart attack or stroke, and also have been found to cause stomach bleeding and ulcers.

To reduce the risk of side effects, make sure that you don’t exceed recommended doses and use the medicines only when necessary.

“Side effects to these types of medications are fairly rare, except for in people who have prior problems, such as stomach ulcers,” Gallagher said. “You should always read the instructions that come with the medicine and weigh the risks and benefits.”

The best thing is to consult with your doctor about all medicines you take, including OTCs.

Topical pain relievers, such as Apercreme, Icy Hot or Ben-Gay, also are available without a doctor’s prescription. These contain different ingredients, such as capsaicin, a substance found in chili peppers; salicylate, the pain-relieving substance found in aspirin; and menthol or mint oil.

Gallagher advised that when possible, you should work on treating pain by methods other than medicine.

Massage, ice or heat, physical therapy and exercise are safe and often effective methods of treating pain, she said.

“It’s important to think about the source of the pain, and whether there’s something other than pain medicine that can relieve it,” she said.

Contact Susan Shelly: life@readingeagle.com.

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