Best Over-the-Counter Pain Relievers and Fever Reducers

Acetaminophen

Brand names: Tylenol and others

Acetaminophen Uses

Acetaminophen is one of the most recommended OTC pain relievers and fever reducers available. It works by blocking pain signals in the brain. It is often the first choice for treating headaches and is an effective fever reducer. It is also used to treat:

• Colds
• Muscle aches
• Arthritis
• Backache
• Toothaches

If you are using acetaminophen, be careful not to take more than indicated on the label or by your healthcare provider. It is one of the most commonly overdosed medicines. Acetaminophencan cause liver damage if you take too much or if you have certain diseases.

Acetaminophen is often added to multi-symptom cold and flu remedies as well as to some prescription medications. That's why you must be especially careful when taking these in addition to acetaminophen.

If you're not careful, you may reach an overdose level accidentally. Such multi-symptom products should not be given to children under 6 years of age in any case.

Contraindications

The American Academy of Pediatrics states that acetaminophen should not be used for an infant under 12 weeks of age unless directed by your healthcare provider. Call your child's healthcare provider for any fever in a newborn or young infant.

Acetaminophen is considered the best pain reliever for those who are pregnant or breastfeeding, but it still should be used carefully. Talk to your healthcare provider before taking it if you fall into either of those categories.

Do not use acetaminophen if you have three or more alcoholic drinks each day. If you plan to drink one or two alcoholic drinks each day while taking acetaminophen, discuss this with your healthcare provider or pharmacist first.

Ibuprofen

Brand names: Advil, Motrin, and others

Ibuprofen Uses

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It reduces swelling and pain, but it is not a steroid. NSAIDs work by blocking an enzyme called cyclooxygenase (COX). This prevents the formation of chemicals in the body known as prostaglandins, which help control inflammation in the body.

Because ibuprofen reduces inflammation, it is better than Tylenol at treating this type of pain. It is often the first choice for treating menstrual pain and sore muscles. It is also used to treat:

• Sore throat
• Fever
• Arthritis pain
• Sprains and strains

Even if you don't have a fever, taking ibuprofen may bring you some relief from the pain caused by the common cold or flu.

Contraindications

Some people shouldn't take ibuprofen. This includes those who have ever had an allergic reaction to a pain reliever or fever reducer.

As an NSAID, ibuprofen may raise the risk of heart attack or stroke in those who have risk factors. These risk factors include people who:

• Have a history of heart disease
• Are smokers
• Have high cholesterol
• Have high blood pressure
• Have diabetes

Do not take ibuprofen:

• Before or after heart surgery
• Before other surgical procedures

Ibuprofen can lead to ulcers or bleeding in the digestive tract. It may also cause side effects such as

• Constipation
• Diarrhea
• Gas
• Dizziness
• Ringing in the ears

If you are pregnant, discuss ibuprofen with your healthcare provider before taking it.

Naproxen

Brand names: Aleve and others

Naproxen Uses

Naproxen is the strongest available OTC pain reliever. It is often the first choice for treating moderate pain due to injury and pain related to conditions such as ankylosing spondylitis and osteoarthritis. 

Naproxen is also used for:

• Fever
• Inflammation
• Back pain
• Menstrual cramps

Like other NSAIDs, naproxen works by blocking prostaglandins (hormone-like substances that the body produces in response to injury or illness).

Contraindications

You should not take naproxen if you have a history of:

• Heart disease
• Stroke
• Gastrointestinal problems
• Liver problems

Talk to your healthcare provider before giving naproxen to a child under 12 years old. They can help you find the appropriate dosage.

You should also talk to your healthcare provider before taking naproxen if you are 65 or older. A smaller dosage may be recommended. The lower dosage will still be effective, and it is less likely to cause serious side effects in older people.

Aspirin

Brand names: Bayer, Ecotrin, and others

Aspirin Uses

Classified as a salicylate NSAID, aspirin relieves pain, fever, inflammation, and swelling. Healthcare providers often prescribe aspirin to treat symptoms associated with:

• Rheumatoid arthritis
• Osteoarthritis
• Lupus
• Other rheumatic conditions

Many people take low doses of aspirin to prevent heart attacks and stroke.

Contraindications

Talk to your healthcare provider before taking aspirin if you have asthma or drink three or more alcoholic beverages a day. Aspirin prevents blood from clotting, so do not take it with blood thinners, also known as anticoagulants. You should not take it with ibuprofen either.

Additionally, do not give aspirin or a product containing aspirin or salicylates to a child or teenager under age 19. You should not give them aspirin especially when they have a viral illness, including influenza.

If you are pregnant or breastfeeding, you should not take aspirin. Talk to your healthcare provider if you become pregnant while taking aspirin so that you receive proper monitoring.