Choosing an over-the-counter pain reliever

When you’re in pain, you want quick and effective relief. Over-the-counter pain medication (also called analgesics) can usually relieve mild to moderate pain, sore muscles, menstrual cramps and tooth aches… but first you need to choose the right product!

Choosing an analgesic depends on the type and intensity of your pain, as well as your age, state of health, and any other medication you may be taking, if applicable.

Acetaminophen

Acetaminophen is the first choice in many situations, since it is well tolerated and is effective against both pain and fever.

Persons with liver problems (including individuals who consume alcohol on a regular basis) should check with their doctor before taking acetaminophen.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

There are four non-prescription NSAIDs: ibuprophen (e.g. Motrin and Advil), naproxen (Aleve and Motrimax), diclofenac (Voltaren Emulgel), and acetylsalicylic acid (ASA – Aspirin and other brands). Naproxen and diclofenac are kept behind the counter at the drugstore because pharmacists must assess each case to ensure that the medication is suitable. Diclofenac is offered as a gel to apply locally, whereas naproxen is available in the form of tablets.

Nowadays, ASA is mainly used for the prevention of heart disease, but it is also indicated to relieve various types of pain, just like other NSAIDs.

As their name indicates, these analgesics also have an anti-inflammatory effect. They are a good option when there is swelling along with the pain, for example in the case of a sprain or dental procedure. As with acetaminophen, NSAIDs can also be used to reduce a fever.

NSAIDs are usually well tolerated in healthy individuals, but it is recommended that oral forms (tablets, capsules, etc.) be taken with food, in order to reduce the risk of stomach irritation.

NSAIDs are not suitable for everyone. Individuals with lupus or with heart, lung or liver disease should consult their physician before taking this type of medication. Pregnant or breastfeeding women should not use NSAIDs unless instructed otherwise by their doctor. Persons who are taking other medication should also consult their pharmacist to ensure that there is no interaction with NSAIDs.

There are so many formulations; which to choose?

Acetaminophen and ibuprofen are available in many different formulations, so it’s important to read the label carefully to make sure you are choosing the right product.

In some cases, the product only contains the analgesic, but at varying doses (e.g. regular or extra-strength) or in a different form (e.g. tablet, caplet, capsule). The form doesn’t affect the effectiveness of the product, but it can have an impact on how fast it acts.

Liquid gels usually take effect faster than tablets. Long-acting and extended-release formulations have a longer-lasting effect than regular forms. Read the label carefully for information on the duration of the product’s effect and the frequency at which you must take it.

Products intended for children are often available in liquid or chewable tablet form. In the case of liquid forms, it’s important to use the measuring tool provided. Until the age of 12, use the child’s weight to determine the appropriate dose (and not the age), especially in the case of children who are at one end or the other of the growth curve.

Manufacturers may also add other ingredients to their analgesics, so always take the time to read the list of ingredients. For example, nighttime formulations may simply contain a longer-acting form, or they may also contain a second ingredient that causes drowsiness. Products designed for muscle aches may contain a muscle relaxant.

BE CAREFUL! If the product contains ingredients other than the analgesic, make sure it is okay for you to be taking all of these ingredients. Read the warnings on the label, and when in doubt, consult your pharmacist.

As a rule, you should not take more than one non-prescription analgesic at the same time, especially not two NSAIDs (including aspirin), due to the increased risk of adverse effects. If you don’t obtain pain relief with an over-the-counter product, it’s best to see your doctor.

Other than taking an analgesic, what else can you do to relieve your pain?

If your pain is recent and is accompanied by swelling, you can apply ice (or a cold “magic bag”) to the painful area for about ten minutes at a time, three to four times per day. Never apply ice directly to the skin; place it in a plastic bag and wrap it in a dishcloth or thin towel.

If the injury is to a limb (an arm or leg), you should keep the limb elevated and rest it for a few days. You can use a stretch wrap to stabilise the area. Your pharmacist can show you how to do it properly!

If you suffer from chronic pain, a bit of heat may help relax the sore area. You can use a heated “magic bag” or a heating pad, but be careful not to burn yourself!

If you’re not sure which product to use, don’t hesitate to consult your pharmacist!