Pain Relievers: The difference between OTC medications? | LowestMed

When you have a headache, what do you reach for? Is it Tylenol? Or perhaps you grab a couple of Advil or Aleve. Maybe you’re a traditionalist and take a couple of aspirin. Whatever you take, you know that it’s going to make that aching head of yours feel better. But what are the differences between the four most common pain relievers? Does one of them work better than the others? And is there anything that you should be wary of when taking them? This article will help you make an informed decision about what pain reliever you choose to use.

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There are two major types of over-the-counter pain relievers. The first is acetaminophen.

Acetaminophen is best known by its brand names Tylenol or Excedrin. It was approved for sale by the FDA in 1955. This is one of the most popular pain relievers with over 28 billion doses sold per year in the United States alone.

Still, for all of its popularity, you should know that acetaminophen is best used for pain that has not been caused by inflammation. This means that a dose of Tylenol will work great on that headache, but you shouldn’t use it if you have a sports injury. Additionally, because it doesn’t reduce inflammation, it doesn’t relieve menstrual cramps very well at all.

Tylenol is easier on the stomach than any of the other pain relievers on the list. But that comes with a cost. If you take more than the recommended dose of 325 mg or drink alcohol with it, you are at risk of severe liver damage.


The second type of pain reliever available without a prescription is an NSAID, or Non-Steroidal Anti-Inflammatory Drug. Essentially, this means that the drug reduces inflammation and relieves pain by blocking enzyme activity that signals distress and pain to your brain.

Aspirin is an NSAID and one of the oldest pain relievers known. The scientific name for this analgesic is salicylic acid, and it can be found in a wide variety of plants. One of the most common sources is willow bark. The ancient Egyptians were known to use shredded willow bark tea as a pain reliever. The ancient Greeks also used it, and Hippocrates, one of the first physicians wrote that the leaves and bark of the willow would relieve fevers and pain.

The modern form of aspirin came about in 1899 when Bayer began distributing a powdered aspirin to doctors. This aspirin was buffered, which blunted the effects of salicylic acid on the stomach. Patients who took unbuffered raw salicylic acid often vomited or suffered extreme nausea. All modern aspirin is buffered to reduce stomach irritation.

As an anti-inflammatory drug, aspirin can be used to treat numerous types of pain, from simple headaches to sports injuries. Taken regularly, it also reduces the risk of heart attack. It does this by stopping the production of prostaglandins, a hormone that is a key to forming clots.

It is for this reason that aspirin should never be taken by someone with a clotting disorder such as hemophilia.


Ibuprofen came about in 1974 and is also an NSAID. It is marketed under the name Advil, Motrin, or Midol (as a menstrual pain remedy). It is worth noting, however, that ibuprofen is better at treating inflammation and injuries to soft tissue. This is why your dentist gives you ibuprofen after a regular filling instead of Tylenol. Ibuprofen is also the best at relieving menstrual pain, which is why it is marketed as such.

Ibuprofen is milder on the stomach than aspirin, although it can still irritate some people. Additionally, like aspirin, ibuprofen is a blood thinner. The effect it has is much smaller than aspirin, so if you are concerned about that, ibuprofen is a better choice.

There have been concerns and studies that show ibuprofen is linked to kidney damage. If you are concerned about this, speak with your doctor to find the best course of treatment.


This is the newest pain reliever in the over-the-counter category. Before 1994 it was only available with a prescription. Now it is available and marketed as Aleve. This NSAID is used to treat inflammations, pain, and fever. Naproxen has been shown to relieve migraine headaches, as well as arthritic pain and menstrual cramping.

Because it is a powerful pain reliever, Naproxen is even more irritating to the stomach than aspirin. This side effect can be offset by the need to take fewer doses, however. It is still recommended that you take this drug with food and/or plenty of water.

Bottom Line

No matter which pain reliever you choose, or what course of pain relief you follow, the most important thing is to pay attention to the directions on the label. If you are taking other medication or aren’t sure what effects these over-the-counter pain relievers will have, consult your doctor. Between you and your health care professional, you can decide on an appropriate course of medication to help you with your aches and pains.