Using Over-the-Counter Painkillers Safely
Over-the-counter painkillers are so commonplace that it’s easy to forget they are drugs with potential risks. Before I put it together that OTC doesn’t mean harmless, I used to take ibuprofen (Advil) throughout every day. Then stories of liver damage, kidney damage, ulcers, and medication overuse (rebound) headache scared me. With careful use, the risk is low. As a Harvard Health publications sums it up, “be cautious, but not afraid.” Here’s some information for using OTC painkillers safely.
To take OTC painkillers safely:
- Know the strength of your pills. Acetaminophen is available OTC in 325, 500, or 650 mg pills. Instead of looking at the number of pills you’re taking, consider how many total milligrams you’re taking.
- Don’t exceed the recommended dose for each dose or in each day. It’s tempting to take a little extra for more pain relief. That strategy is ineffective for acetaminophen, according to the FDA, and increases the risk of stomach bleeding with ibuprofen or naproxen.
- Take them for only a short time. All the OTC bottles say to contact your doctor if your symptoms don’t improve within two weeks. I always thought it was because you might have an underlying condition that needed to be treated. It’s actually that long-term use can be dangerous. (Long-term use isn’t always dangerous, but should only be done under a doctor’s supervision.)
- Know the active ingredients of all the drugs you take, prescription and OTC. If they contain acetaminophen, ibuprofen, or naproxen, do not take those medications at the same time.
- Ask your doctor or pharmacist about drug interactions. Prescription medications can interact with OTC medications.
- Moderate your alcohol intake when taking OTC painkillers. Alcohol can increase the toxicity of the drugs, making them dangerous at even low doses. A Harvard Health publication recommends that men have no more than two standard drinks a day when taking acetaminophen and that women stop at one drink.
Ibuprofen was my drug of choice, but the same guidelines apply to acetaminophen (Tylenol) and naproxen (Aleve). Acetaminophen is of particular concern because it is an ingredient in more than 600 products. Few people add up the amount of acetaminophen in all the drugs they take, which puts them at greater risk of liver damage. It also takes less to reach an overdose level with acetaminophen than it does with NSAIDs like ibuprofen and naproxen.
OTC painkillers aren't candy, but they are safe and effective when used correctly. Talk to your doctor or pharmacist if you're concerned about using these drugs.
REFERENCES
A Guide to Safe Use of Pain Medicine. FDA. Feb. 23, 2008.
Acetaminophen safety: Be cautious but not afraid. Harvard Health Publications. Jan. 1, 2014.
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