Advil, Tylenol or Aleve? Here's how to choose the right pain reliever

Choosing the right over-the-counter pain medication can make a significant difference in how effectively pain is treated, according to a Texas A&M University pharmacy expert who says consumers should understand the differences between common medications before reaching for relief.

Dr. Frank North, an instructional assistant professor at the Texas A&M Irma Lerma Rangel College of Pharmacy, said many people mistakenly assume that over-the-counter medications are completely risk-free simply because they do not require a prescription.

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What they're saying:

"Oftentimes people think that just because you can pick it up from the counter means that there is no risk associated with it," North said. "Our over-the-counter products are medications that, if used appropriately and safely, can be used for self-care, which means not under the supervision of a physician."

North said the three most common OTC pain relievers—acetaminophen, ibuprofen and naproxen—work differently and are designed to treat different types of pain.

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Which pain reliever? 

Why you should care:

Acetaminophen, sold under brand names such as Tylenol, is an analgesic that primarily reduces pain and fever. Ibuprofen and naproxen, marketed as Advil, Motrin and Aleve, belong to a class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs), which help reduce inflammation that often causes pain.

"Analgesics work to reduce pain and reduce fever," North explained. "That is different than our nonsteroidal anti-inflammatory drugs that commonly reduce swelling or inflammation that then treats the pain."

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Understanding those differences can help consumers choose the most effective medication for their symptoms while minimizing side effects.

"If we're taking naproxen or ibuprofen, we want to make sure that we take it with food because there are some short-term side effects that can occur in terms of GI upset or increased bleeding in the stomach," North said.

Big picture view:

He also warned that long-term misuse of pain relievers can carry more serious health risks, including kidney disease, cardiovascular complications and liver toxicity, particularly when acetaminophen is taken above the recommended daily limit.

In some situations, North said acetaminophen and NSAIDs can be taken together or alternated to provide additional pain relief, provided users carefully follow dosing instructions.

"If the pain is from inflammation or something that's swollen, we can take an NSAID," he said. "But if we feel like that swelling is not going down fast enough and there's pain associated with it, then we can take the acetaminophen with it as well."

Consumers suffering from migraine headaches may also benefit from medications containing caffeine, North added.

"Caffeine has been shown to also reduce some pain, particularly headaches and migraines," he said. "Another alternative is being able to identify what's triggering the migraine or what's triggering the headache because if you can mitigate those triggers, then you can reduce or not have the headaches or the migraines."

What you can do:

North encourages consumers to take advantage of one of the most accessible healthcare resources available—their pharmacist.

"Pharmacists are medication experts," he said. "We're often the most accessible healthcare professional that a patient can see without an appointment."

He said pharmacists can help patients select the most appropriate medication based on factors such as age, the source and severity of pain, and whether an oral or topical treatment is the better option.

"So there's value in talking to the pharmacist and getting access to the right medication that's going to do the right job at the right time and the right dose for the patient," North said.

As pharmacy aisles continue to offer an expanding selection of pain relief products, North said understanding how these medications work—and seeking professional guidance when needed—can help consumers treat pain safely and effectively.

Health