A Comparison of Over-the-Counter Painkillers: Which One Is Right for You?

Experiencing pain is part of our nature, and thankfully there are plenty of over-the-counter (OTC) painkillers available that can keep you from experiencing headaches, muscle pain or a broken bone.

But with so many available (acetaminophen, ibuprofen, aspirin, naproxen and so on), it can be difficult to know which one is right for you. Which one works best for your specific discomfort? Are some safer than others? And when to steer clear of certain ones?

Below we’ll cover the most popular over-the-counter painkillers, how each works, when to use each, and what you should know when using them safely. By the end, you’ll be much more confident about which painkiller is best for you — and how to make the right decision, every time.

The Big Four: Most Common OTC Painkillers

When you go to the drugstore, you will almost certainly see 4 primary categories of over-the-counter painkillers:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)
• Aspirin (Bayer)
• Naproxen (Aleve)

Each of these pain relievers works in a different manner and is a more appropriate option for certain kinds of pain or symptoms. But before we jump to those, let’s first define the general categories.

NSAIDs vs. Acetaminophen

You’ve likely heard of NSAID, the Non-Steroidal Anti-Inflammatory Drug. These include the likes of ibuprofen, aspirin, and naproxen. These medications work to diminish inflammation and pain as the name implies. Acetaminophen, meanwhile, is not an NSAID. It prevents pain and decreases fever, but it cannot combat inflammation.

Acetaminophen: General Pain Relief Choice

If you’ve ever had a headache or mild pain and popped a Tylenol, you’ve already consumed acetaminophen. It is everyone’s first choice since it’s efficient, widely available and generally considered safe with proper use.

How It Works

Acetaminophen numbs pain-stimulating chemicals in the brain. It is an excellent remedy for pain not specifically related to inflammation such as headaches, moderate muscle pain, toothaches, and cramping during periods.

When to Take Acetaminophen

• Headaches: Especially tension headaches or light migraines.
• Fever: Acetaminophen is wonderful for cooling down fever without the gut irritation of an NSAID.
• Minimal pains: Non-inflammatory, general body pains.
• When NSAIDs aren’t good: Acetaminophen is usually better than NSAIDs if you have a sensitive stomach, are at risk of ulcers, or suffer from kidney problems.

Potential Side Effects

Acetaminophen is softer on the stomach, but make sure not to overdose as you can damage your liver by using it in conjunction with alcohol. Follow the dosage indicated on the label, and if you’re not sure, check with your doctor.

Unlike other common pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen does not raise the risk of stomach or heart problems, making it a go-to medication for people who are unable to tolerate NSAIDs (Acetaminophen: Is it as safe as we think? – MedicalNewsToday).

Pro Tip: Check the ingredient list for acetaminophen if you take another medicine. Many cold and flu medicines contain it, so you could accidentally double up and go over the recommended amount.

Ibuprofen: Great for Reducing Inflammation

Ibuprofen is a widely used non-steroidal anti-inflammatory medication (also sold as Advil and Motrin). What makes ibuprofen unique is that it does both, reducing pain and inflammation, and is the go-to choice for those with a chronic disease in which inflammation plays an important role in pain.

How It Works

Ibuprofen prevents the body from making prostaglandins – molecules that create inflammation and pain. This is why it’s an excellent option for bruising and other cases where swelling is involved.

When to Take Ibuprofen

• Muscle aches and sprains: If you are dealing with workout soreness, muscle tension or injury, Ibuprofen may reduce swelling.
• Menstrual cramps: For most women, ibuprofen is especially effective in period pain because it inhibits cramping and inflammation.
• Arthritis: If your joint pain or stiffness is inflammation, ibuprofen can be helpful.
• Fever: Like acetaminophen, ibuprofen can reduce fever too.

Potential Side Effects

NSAIDs, even when effective, like ibuprofen, will dry out the stomach and may produce discomfort, vomiting, or even ulcers if consumed too often or on an empty stomach. Excessive use also puts you at increased risk of kidney problems or blood pressure spikes.

NSAIDs can cause sodium and fluid retention (especially in the elderly) and increase blood pressure or worsen pre‐existing high blood pressure. (Kidney damage from nonsteroidal anti‐inflammatory drugs—Myth or truth? Review of selected literature).

Pro Tip: Don’t take ibuprofen with food as it can cause stomach pains. If you need it longer than several days, speak to your physician.

Aspirin: Excellent For Heart Health, Use Carefully for Pain

Another NSAID is aspirin, but it’s usually more associated with heart health than with pain management. Aspirin is often prescribed in low doses for the prevention of heart attack or stroke because it thins the blood. That being said, it’s still very effective for pain and inflammation relief.

How It Works

Aspirin inhibits prostaglandins such as ibuprofen, which ease pain and inflammation, but also weakens the blood’s ability to clot, hence the reason for its low-dose application to ward off heart attacks.

When to Use Aspirin

• Heart disease: If you’ve been prescribed a low dose aspirin a day by your physician, it can help to prevent blood clots.
• Mild aches: If you’re suffering from mild aches, headaches or a fever, aspirin will still work (although it’s not the go-to treatment anymore).
• Inflammation: As ibuprofen, it is excellent for inflammation-related pain.

Potential Side Effects

Aspirin is stomach irritating. The long term use can cause stomach irritation, ulcers or gastrointestinal bleeding at higher doses. If you have any stomach or blood thinner history, aspirin will not be your friend.

Aspirin often causes acute gastric mucosal damage that can be seen endoscopically or assessed indirectly (for example, by measuring increased gastrointestinal blood loss). The occurrence of most adverse effects is apparently related to the dose administered. This dose-response effect, evident in both endoscopic and microbleeding studies done after acute or short-term aspirin administration, is also associated with the risk of developing chronic gastric ulcer (Aspirin and the stomach).

Pro Tip: Don’t take aspirin with children under 18— a rare, but lethal, condition called Reye’s syndrome has been associated with aspirin taken by children especially following viral illness, such as the flu.

Naproxen: Ideal for Long-Term Treatment

Naproxen (brand name Aleve) is another NSAID, but unlike ibuprofen, it does not go away. If you should take ibuprofen every 4 or 6 hours, you can get off your naproxen only twice a day, which is perfect for chronic pain.

How It Works

Naproxen also acts by inhibiting prostaglandins to help alleviate pain and inflammation, but it remains in your body longer than ibuprofen, so it’s a better option for ongoing long-term relief.

When to Take Naproxen

• Arthritis: Naproxen is a suitable choice for chronic inflammatory pain, such as osteoarthritis or rheumatoid arthritis, because of its prolonged effectiveness.
• Muscle aches: Excellent for sore muscles or pains where swelling occurs.
• Period cramps: Naproxen may be a better alternative to ibuprofen, which gives you more of a lasting relief.

Potential Side Effects

Naproxen is harsh on the stomach like all NSAIDs, so take with food. It has similar dangers for permanent kidney failure or high blood pressure when used too much.

Naproxen does not influence total acid secreted but does decrease basal gastric fluid volume, thereby increasing basal gastric acid concentration. These observations define one mechanism by which non-steroidal anti-inflammatory drugs may induce gastric injury (Effect of naproxen on gastric acid secretion and gastric pH).

Pro Tip: If you have pain that needs to be treated throughout the day, but doesn’t require repeated treatments, naproxen’s 12-hour relief beats out ibuprofen.

So What Painkiller Should You Pick?

With four of the most common OTC painkillers now covered, how can you tell which is right for you? Here’s a little breakdown to help you make the decision:

• For general pain and fever: Acetaminophen will work, especially if you don’t want stomach cramps. Ibuprofen or naproxen are your best friends. If you want an immediate fix that disappears in an instant, use ibuprofen. For more lasting relief, choose naproxen.
• Heart health and inflammation: Aspirin can ease pain and inflammation, but isn’t recommended for those seeking to guard against cardiovascular disease. But if pain management is what you’re after, then don’t turn to aspirin.
• Chronic ailments: Naproxen’s long lasting action makes it a good choice for arthritis or chronic back pain.

Medications and Safety / Warnings For Non-Potential Drugs

While prescription painkillers are generally safe, there are cases when you need to take caution, or stay away from them:

• Kidney Disease: NSAIDs such as ibuprofen and naproxen have a longer side-effect on the kidney, so stay away from them if you have kidney disease.
• Health Problems with Your Liver: Acetaminophen damages your liver if you have alcohol in your system. Follow the dose and consult with your doctor if you have liver issues.
• Pregnancy: NSAIDs should not be used in the third trimester of pregnancy. Acetaminophen is usually the best option during pregnancy, but always speak with your doctor.
• Children: Never use aspirin in children as it may cause Reye’s syndrome. For a child older than six months, Ibuprofen and acetaminophen are better choices.

Which Painkiller Is Right For You?

Finding the right OTC painkiller need not be complicated. It’s about identifying what pain you have and matching it up to the best remedy. Whether it is acetaminophen for numbness, ibuprofen for swelling, or naproxen for permanent relief, you have plenty to choose from.

The takeaway here is, take these medications at your own risk, do so at your prescribed level, and consult with your physician if you have questions. After reading up on the best pain medications for you, you can feel better in the end and resume life as comfortably as you can.

Where to buy painkillers

Here are the most reliable and trusted sites where you can purchase painkillers:

So what’s your everyday ache painkiller? Let us know about your experience in the comments.