3 Essential Questions to Answer Before Taking An OTC Pain-Relief Medication

How much do you want to bet that there is at least one type of over-the-counter (OTC) pain-relief medication in your house? With such a huge number of available OTC medications on the market, we would bet the odds are in our favor. Drugs such as ibuprofen, aspirin, acetaminophen, and naproxen are some familiar medication names and all fall into the spectrum of OTC pain relievers. But have you done your due diligence and made sure you’re not putting yourself at risk before deciding to take these drugs, or do you know which OTC medication is best for your current condition? Unfortunately, the answer for many people is, “no”; but it’s not their fault! Yes, these are medications that do not require a doctor’s prescription, but they can pose a risk for some, where proper education is needed.

Warnings as well as research done by the U.S. Food and Drug Administration (FDA) have often called over-the-counter pain-relief medications’ safety into question. For example, the FDA disseminated a warning that non-steroidal anti-inflammatory drugs (NSAID’s) may raise the risk of heart attack and stroke. Unless you’re an avid FDA news savant, studied pharmacology, or spent years in medical school; the general public is just not equipped with the knowledge to determine if they can safely take these medications. But you’re in luck! We would like to go over three essential questions you should be able to answer before you head to the nearest Walgreens for some Tylenol®; however, please talk to your doctor before taking an OTC pain-reliever. He or she knows you best and will help guide you in the appropriate direction in reaching pain-relief.

Why have you turned to a pain-relief medication?

The cliché, “more bang for your buck” is appropriate here. Anyone taking a medication wants to take the lowest dose possible with the minimum risk of side effects while having the most therapeutic effect possible. Let’s say you are dealing with osteoarthritis. Research has found that acetaminophen has been shown to be favorably effective at relieving osteoarthritis symptoms. Studies have also found that acetaminophen is effective at treating headaches while avoiding side effects regarding cardiovascular or digestive diseases. We must note that this is assuming acetaminophen is the only medication you are taking (we’ll go into further detail later). On the other hand, NSAID’s may pack a punch against dysmenorrhea (painful menstrual cramps) and muscle aches for some patients.

Do you currently suffer from other conditions?

Before considering what medication to take, have in mind if you also have conditions other than the chief complaint. For example, NSAID’s like Aleve® & Advil® can be hard on the digestive system where long-term use of these medications cannot only upset your stomach but may pose a risk for severe stomach ulcers. If you suffer from digestive diseases, consult a doctor before taking Advil® or Aleve®. The same goes for those who have kidney disease, because NSAID’s can decrease blood flow to the kidneys.

Recently, the FDA released a warning about NSAID’s identifying those who have had a recent bypass surgery or heart attack, specifically. If you fit into these categories, it is all the more reason to consult your doctor before taking a pain medication. For instance, acetaminophen might be a better choice for you. To drive home how OTC pain-relief drugs can exacerbate multiple conditions, if you suffer from liver disease, avoiding acetaminophen (e.g. Tylenol®) is in your best interest because of the potential negative symptoms acetaminophen can have on the liver. These are just a few examples among many. If you’re in good health, such concerns may not apply to you. But any chronic condition will play a part in drug safety.

Are there other medications you are currently taking?

Polypharmacy, or rather taking more than one medication concurrently, contributes significantly as to if you should be taking an OTC pain-relief medication or not. Most drugs undergo metabolism by the same enzymes in the liver. These interactions between drugs, also known as drug-drug interactions (DDI’s), can influence the overall effect of a given medication. Some drugs may synergize the response of other drugs while some drugs can inhibit the reaction of others. For example, if you are taking a blood thinner such as warfarin, adding NSAID’s for pain-relief significantly increases your risk of hemorrhaging (bleeding), while acetaminophen in higher doses may have a mild interaction with warfarin, it may be a better choice if your doctor advises it.

What we would like you to take away from this article is that if you are suffering from a chronic condition such as rheumatoid arthritis or degenerative disc disease, it is entirely ok to ask for your doctors’ and pharmacists’ advice. The package inserts that come with prescription medications can be a lot to process and so can the labels on over-the-counter drugs. A little expert advice on drug interactions can help you get the pain-relief you need while avoiding unwanted side effects. Once you and your healthcare team have decided on an over-the-counter medication that works best for you, remember to take it with caution considering the minor side effects that are mentioned on the package. Even then, take it only when needed and take the least amount that controls your symptoms. Which over-the-counter drugs have worked for you? Let us know!

Tags: painkiller, pain reliever, NSAID’s, adverse side effects, pain management

References:

  1. FDA Consumer Health Information. COX-2 Selective (includes Bextra, Celebrex, and Vioxx) and Non-Selective Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). fda.gov/consumer. April 2005.
  2. FDA Consumer Health Information. FDA Strengthens Warning of Heart Attack and Stroke Risk for Non-Steroidal Anti-Inflammatory Drugs. www.fda.gov/consumer. July 2015.
  3. Lenzer J. FDA advisers warn: COX 2 inhibitors increase risk of heart attack and stroke. BMJ 2005;330:440.
  4. Moling O, Cairon E, Rimenti G, Rizza F, Pristera R, Mian P. Severe hepatotoxicity after therapeutic doses of acetaminophen. Clin Ther 2006;28:755–760.
  5. Rampal P, Moore N, Van Ganse E, Le Parc JM, Wall R, Schneid H, Verriere F. Gastrointestinal tolerability of ibuprofen compared with paracetamol and aspirin at over-the-counter doses. J Int Med Res 2002;30:301–308.