Can Over-The-Counter Pain Relievers Be Harmful, Are They Safer Than Other Drugs?

Dr. Portenoy answers the question: 'Over-The-Counter Pain Relievers Harmful?'

ByRussell Portenoy, M.D., Chairman, Department of Pain Medicine and Palliative Care, Beth Israel Medical Center
November 11, 2008, 4:19 PM

— -- Question: Can Over-The-Counter Pain Relievers Be Harmful, And Are They Safer Than Other Drugs (Narcotics)?

Answer: There are many pain relievers available over-the-counter in pharmacies. And a common question is whether or not these pain relievers are necessarily safer than stronger medications such as the narcotic drugs or the opioids.

The answer to that question depends on the specific pain reliever being discussed. If one is talking about medications, the pain relievers available over-the-counter consist of acetaminophen, which is the most commonly used one, and a number of anti-inflammatory drugs.

Acetaminophen is a safe drug for sure, but only is safe if it is not taken at an excessive dose. Patients who take acetaminophen for body pain or for headache should not exceed a dose of three to four grams per day.

The over-the-counter anti-inflammatory drugs are also quite safe, but patients should understand that these drugs do carry risks. The most common type of toxicity associated with these drugs is a development of ulcers or gastritis. But there are also other concerns. And if a patient has a number of medical problems or a patient that has had symptoms of GI distress, or the patient has had a history of ulcer problems in the past, even these drugs should not be taken unless discussed first with a physician.

Other pain relieving compounds in the pharmacy are topicals, they're creams that can be rubbed on a painful area. Some of these creams like capsaicin actually have been shown to be helpful and could be used by patients who have musculo-skeletal pains. These are generally quite safe and might be considered as part of a larger strategy to treat pain or possibly used instead of stronger drugs that have more side effects.

Next: Why Do Some Over-The-Counter Pain Killers Contain Caffeine; Is That Good?

Previous: What Are Muscle Relaxants And When Are They Used To Treat Pain?

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