Health NW: Choosing an over-the-counter pain medicine

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Whether you have ongoing pain or just an occasional headache, deciding which over-the-counter pain medicine to use can be a challenge. A visit to your local supermarket or drug store's pain medicine aisle is overwhelming unless you know what you are looking for. Read on for some basic information about the various types of over-the-counter pain remedies.

Every person's body is unique, so we each respond to different medicines in different ways. This is why some people believe that aspirin is the only pain medicine that works, whereas others swear by acetaminophen. Just because a drug works well for someone else, don't assume it will work for you.

Before choosing a pain medicine, you need to take into consideration your personal health history, including your use of other medicines and alcohol. If you are taking any over-the-counter pain medicine regularly, talk to your health care provider for advice. Don't be fooled into thinking that over-the-counter drugs are perfectly safe; they can cause serious problems, just as prescription drugs can. Pregnant women should be especially careful with all drugs, including herbal supplements.

First, some definitions:

• Generic name: the common name of a drug. Many different companies may manufacture the same generic drug. An example is ibuprofen.

• Brand name: the name a manufacturer gives to their drug. Example: Advil' and Motrin' are brand names for ibuprofen.

The Food and Drug Administration (FDA) requires generic drugs to have the same quality, strength, purity and stability as brand-name drugs. So, the main difference between the two is cost: generic drugs are less expensive.

Aspirin is one of the oldest and most common pain relievers. It works by blocking the body's production of prostaglandin, which is a substance that causes pain by stimulating muscle contractions and dilating blood vessels. It also is an anti-inflammatory and a fever reducer. It acts as a blood thinner, which prevents platelets in the blood from clotting.

Aspirin can work on any type of pain, including arthritis, headaches, muscle aches, menstrual cramps and injuries. Health care providers sometimes recommend a daily aspirin for their patients who are at risk of a heart attack, stroke or colon cancer. Side effects can include stomach problems like irritation and bleeding, ringing in the ears, asthma or other allergic reactions. It should never be given to children who have the flu, chicken pox or another viral infection.

Acetaminophen is the generic name for Tylenol'. It is generally considered the safest of the over-the-counter pain medicines, and most pediatricians recommend it for children. People with liver problems, including those who have three or more alcoholic drinks a day, can develop liver damage on this medicine. It works on fever and pain of all types. However, it is not an anti-inflammatory so it is not as good for injuries when there is a lot of swelling, such as with a sprained ankle.

Ibuprofen (brand names Advil' and Motrin'), naproxen (brand names Naprosyn' and Aleve') and ketoprofen (brand name Orudis') are pain relievers, fever reducers and anti-inflammatories. They work in much the same way aspirin does, by inhibiting prostaglandins. Stomach ulcers, liver damage and kidney damage are possible side effects. This type of drug should always be taken with food or milk to reduce the chance of upset stomach.

There are two dietary supplements that are being used for arthritis pain: glucosamine and chondroitin. These are promising options, but since the FDA does not regulate them, it's difficult to if they are safe and effective. Talk to your health care provider if you're thinking of trying these products.

Before you head for the drug store, don't forget the non-drug treatments for pain. Simple things like applying a hot or cold pack, taking a warm bath or shower, massaging the affected area, going for a walk, drinking plenty of water, relaxing by breathing deeply and getting extra rest may be all you need for some types of pain.

Kathryn B. Brown is a family nurse practitioner with a master's degree in nursing from OHSU. Is there a health topic you would like to read about? Send your idea to

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