Pain and Fever Medications

When scanning the drugstore aisles searching for the perfect medication for your aches and pains or fever, the abundance of options may be more overwhelming than beneficial. There are many different over-the-counter (OTC) pain relievers and fever medications. Most of these medications do one or any combination of three things: they can be antipyretic, analgesic, or anti-inflammatory. Antipyretic means that the medication reduces fever. Analgesic means that the drug relieves pain. Anti-inflammatory means the drug reduces inflammation, which can cause swelling, tenderness, fever, and pain.

There are four basic categories of medications: aspirin, ibuprofen, acetaminophen, and naproxen. These medications are sold under brand names and as "generic" or store-brand products and contain the same ingredients as the brand name products, but are usually less expensive.

Aspirin, or acetylsalicylic acid (Bayer, Empirin, Ecotrin, Halfprin, Acuprin, Easprin) is an analgesic, antipyretic, and anti-inflammatory drug. Aspirin is used to relieve mild-to-moderate pain, reduce fever, and treat minor pain due to arthritis. Studies indicate that taking a low dose of aspirin daily may reduce the risk of heart attack or angina (chest pain), so this may be recommended by your physician.

However, aspirin is not without risks. Taking aspirin while you are taking corticosteroid drugs may increase the risk of developing ulcers. Stomach irritation is another common side effect. Some people also may experience bloating, gas, heartburn, constipation, diarrhea, nausea, or vomiting. If you experience ringing in your ears (tinnitus), you may be taking too much aspirin. Drinking alcohol and/or smoking while taking aspirin may increase the risk of developing ulcers.

Ibuprofen (Motrin, Advil, Actiprophen) is an analgesic, antipyretic, and anti-inflammatory drug. Ibuprofen helps relieve pain, stiffness, and inflammation, including headaches, muscle aches, bursitis, arthritis, rheumatism, sprains, over exertion, and menstrual cramps. Children's ibuprofen is used to relieve fever and discomfort due to colds, flu, teething, and immunization.

Although side effects are rare, ibuprofen does have risks. Ibuprofen may reduce the effects of oral contraceptives. Some people experience nausea, stomach cramps, diarrhea, or heartburn. Use with caution if you have ulcers.

The safety and effectiveness of use of this drug in children less than 6 months of age has not been established.

Acetaminophen (Tylenol, Aspirin Free Anacin, Aceta, Abenol) is an analgesic and antipyretic drug used to treat headaches, fever, minor pain, and muscle aches. It may relieve mild pain from arthritis, but may not affect the underlying inflammation and swelling of the joint.

Some side effects of acetaminophen include mild nausea, skin rash or hives, liver damage, and difficulty breathing. Acetaminophen does not cause the stomach irritation often associated with aspirin. This drug may be used in combination with anticoagulants. Reduce the dosage for children under the age of 12 years, and consult your pediatrician before administering to children less than 2 years of age.

Naproxen (Aleve, Naprelan, Anaprox, Naprosyn) is an analgesic, anti-inflammatory, and antipyretic drug used to relieve pain, inflammation, and swelling and reduce fever. It can reduce pain from tendinitis or bursitis, menstrual cramps, headache, arthritis, and other musculoskeletal conditions.

Naproxen may cause stomach irritation and/or nausea. It is not recommended for pregnant women or women who are breastfeeding infants, or people who have asthma or ulcers. People with kidney or liver impairment or bleeding disorders should use this drug with caution. The safety and effectiveness of naproxen for children less than 12 years has not been established.

General Recommendations

When taking any nonprescription medication, always follow the directions provided in the package, or consult your doctor or pharmacist.

• Ibuprofen or acetaminophen may be given to children if the correct dosage is followed. Always read the package directions and recommended dosages carefully. These medications may be packaged as regular (adult) or "extra strength," as well as for "infant," "children's," or "junior-strength" products. There is a difference in the strength and corresponding dosage.
• These drugs may interact with each other or other medications. Tell your doctor or pharmacist about other medications you may be taking.
• In case of suspected overdose, call your regional Poison Control Center.

INTERNET RESOURCES

American Headache Society, www.ahsnet.org/resources/otc.php

American Council on Science and Health, www.acsh.org/publications/booklets/pain_relievers.html

RESOURCES

Consumer Healthcare Products Association, Publications Department, 1150 Connecticut Ave., NW, Washington, DC 20036; www.fda.gov/cder/consumerinfo/WhatsRightForYou.htm