Finding the Right Pain Reliever for You
by Rashi Kabra, University of North Carolina at Chapel Hill
Abstract: Questionnaires based on over-the-counter pain medications and recent research done by health care specialists have been compiled and examined to extract useful information for consumers about two classes of pain relievers: NSAIDs, including naproxen, aspirin, and ibuprofen, as well as acetaminophen. The possible risks, benefits, and uses for each of these over-the-counter pain killers have been outlined. The common belief that all of these pain killers can be used with the same efficacy for all types of minor aches and pains has been disproven. Instead, studies have shown that each pain killer has unique uses and risks, and that each type should only be used by the appropriate customer. Articles outlining the Food and Drug Administration’s efforts with drug abuse and the effects of taking different medicines simultaneously have also been studied and useful information extracted in this report.
Full Article: Open a medicine cabinet in any American household and you are almost sure to find at least one bottle of an over-the-counter pain reliever. Whether it is Motrin, Tylenol, Aleve, or one of several other brands, Americans tend to wash down these pills with complete ignorance of their exact risks, benefits, and ingredients. When given the choice between various brands of pain relievers, many people simply choose the one that is easily accessible at any given moment. When was the last time you chose Advil over Tylenol, simply because you would have had to go to the convenience store and purchase Tylenol, while you had Advil sitting in your cabinet? All of us have done it, but few of us know that Advil and Tylenol are two of the most differing medicines because they contain two completely separate ingredients that best cure different symptoms. Over-the-counter pain medications, specifically naproxen, aspirin, ibuprofen, and acetaminophen, are the leading medicines taken by consumers, and it is therefore important to know their specific uses, as well as the possible complications that may come along with the administration of each pill.
Our first target is a class of drugs named nonsteroidal anti-inflammatory drugs (NSAIDs), including naproxen, aspirin, and ibuprofen. Naproxen, more commonly taken as Aleve or Midol Cramp for women, is known to be one of the best pain killers among its class. However, because it is an anti-inflammatory drug, it is best used not for headaches as many people may be misinformed, but for pain caused by inflammation, such as arthritis and aches from sprains. Women favor Midol Cramp for their menstrual cramps, as can be seen in both my survey data and elsewhere, because it effectively relieves menstrual pain while lasting for long periods of time. A complaint that many naproxen users have voiced, however, is the large amount of time naproxen takes to begin soothing aches and pains. So if you are in need of some immediate relief, naproxen may not be your best choice. Why is naproxen not suitable for everyone? More than the other NSAIDs, naproxen may cause harm to patients with heart conditions. It is possible that it increases the risk of high blood pressure, heart attack, and stroke, especially when used excessively, or over a lengthy period of time. It is also advised to use naproxen with caution if you have stomach conditions, because when used generously, it may cause bleeding from the stomach or intestines. Thus, if you are a patient with no severe heart or stomach conditions (or of course an allergy to naproxen), your search for an NSAID that effectively works for a long period of time could end at naproxen.
Another NSAID on which Americans have become more dependent is aspirin, better known as Bayer or Bufferin. Used to treat headaches, minor aches, and pain caused by inflammation (similar to naproxen), aspirin is often taken daily by its consumers. More recently, research has found that for some individuals, a daily dose of aspirin could be ideal to prevent heart disease or any sort of cardiovascular condition because it prevents platelets from forming blood clots. In this way, aspirin is the better NSAID choice than naproxen for those who could have heart conditions. Thus, a dose of aspirin has become part of a daily routine for much of the adult American population (more than 50 million people, according to CNN chief medical correspondent Dr. Sanjay Gupta). However, many people are under the impression that aspirin works as a cure-all for all body types—a misconception that needs to be set straight. Many people, as Dr. Gupta also states, are aspirin-resistant so aspirin’s job of preventing blood clots does not occur upon consumption of the pill. In fact, “being resistant to aspirin makes patients four times more likely to suffer a heart attack, stroke, or even die from a pre-existing heart condition compared to non-resistant patients” (Gupta). Thus, is it advised that potential consumers of aspirin seek testing from their healthcare providers, who in turn can advise them if their bodies will react to aspirin and benefit from it, or if they are completely aspirin-resistant. Additional risks of excessive aspirin intake include those similar to naproxen’s risks, such as stomach ulcers, gastrointestinal bleeding, and hemorrhagic strokes caused by bleeding in the brain. Aspirin should therefore not be taken lightly as it often is today, but instead should be taken only after appropriate precautions.
Another widely used NSAID in the market is ibuprofen, consumed most often in the form of Motrin or Advil. Although ibuprofen is chemically similar to aspirin and naproxen, and treats inflammation in the same way, it has been found that ibuprofen is easier on the stomach than its fellow NSAID buddies. For this reason, patients with stomach ulcers or gastrointestinal problems should choose ibuprofen as the recommended NSAID for pain involving inflammation, even though this does not ensure the complete removal of risk factors involved with the medication. Research is also currently being done on the possible benefits of ibuprofen (as well as aspirin) on breast cancer. Recent studies show that women who have been taking aspirin, and more effectively, ibuprofen, may have a smaller chance of acquiring breast cancer, although this research is still in its earliest stages and does not yet imply that ibuprofen or aspirin should be taken to prevent breast cancer. Thus, although ibuprofen’s benefits may someday expand, today it should be taken moderately for inflammatory pain.
A constant competition between pain relievers is that between ibuprofen and acetaminophen, the only drug thus far mentioned that does not fall under the NSAID category. You might easily recognize this battle as the one between Advil and Tylenol. However, all the advertising campaigns comparing the two are not exactly accurate. Why? Acetaminophen is not an anti-inflammatory drug like the three that have been discussed, but instead is an antipyretic drug that works best to heal non-inflammatory pains and fevers. Thus, each medicine’s forte deals with a different kind of pain, and both drugs should therefore not be compared as strongly as they are in the media. Tylenol’s risks also differ from the dangers that can come from ibuprofen and the other NSAIDs. Acetaminophen has recently caused controversy in the media because it has been linked to severe liver failure and damage. Taken in excessive amounts, acetaminophen can, and has in numerous cases, caused liver damage to users who were told by their doctors to take Tylenol regularly. Because the usual dose and the overdose amount are not very different, users often find themselves consuming much more Tylenol than they realize, leading to liver damage and sometimes failure. Tylenol should thus be taken with moderation, and certainly not by liver patients. When taken properly, Tylenol can ease pains and fevers wonderfully, not causing any discomfort in the gastrointestinal tract like NSAIDs do. Thus, for patients with ulcers, acid reflux disease, or any stomach condition, Tylenol is a great choice for pains not involved with inflammation and for fever reduction.
Because of all the dangers that could arise from all of these over-the-counter medications and their excessive intake, the Food and Drug Administration has, over the years, put several precautions into place. An important risk the FDA has tried to enforce is the consumption of several pain killers simultaneously, specifically NSAIDs. If one takes aspirin and ibuprofen at the same time, for example, it is highly likely that ibuprofen’s pain relief effects will defeat aspirin’s heart benefits, thus being useless for the daily aspirin user. Most recently, the FDA is requiring new labels to be put on all bottles of pain killers, informing consumers of the risks involved with each medication (Young). Acetaminophen bottles must boldly state not only that the drug can cause severe liver damage, but that it should not be taken simultaneously with other drugs containing acetaminophen, or soon before or after alcohol consumption. NSAID bottles must warn users of severe stomach bleeding, specifically that “alcohol use and taking the drugs for longer than directed can increase the risk of stomach bleeding” (Young). This new law will hopefully help consumers realize the possible harm they could be causing their bodies by incorrectly administering medicines.
In a society that has become increasingly health conscious, many worrying Americans find solace in their daily dose of medicine. Whether it is Advil, Bayer, Tylenol, or Aleve, Americans are now using more over-the-counter pain relievers than ever before. I could have easily chosen to focus my analysis on some of the topics I was earlier considering, such as birth control or migraine medication, but why not inform people about the medicines they take most? Hopefully after reading this analysis and others, you will be able to find the appropriate pain killer to suit your needs. Since research has supported many of these common pain relievers and their uses, it is all good and well that we use them. However, the line between the usual dose and the overdose amount has been drawn, and it is the consumer’s responsibility to ensure the proper amount of medicine has been taken. It is always recommended to check with a healthcare provider before you begin regular use of any drug. After asking several people to fill out the questionnaires on Rate A Drug’s website, I have found that countless people do not even realize what they use medicine for, and more importantly, what dosage of this medicine they take. In order to keep your body healthy and safe, please be familiar with what you are putting into your body, and do not let it become part of a routine if not necessary. We are so fortunate to have medicine readily available to us all the time, so as long as we are careful, we should remain healthy as long as possible.
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